Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN161346 | GA |
NPI | 1003185570 |
---|---|
Provider Name | Jennifer Dykes Price |
First Address | Savannah, GA 31416-2549 |
Second Address | Savannah, GA 31406-3928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2011 |
Last Update Date | 29/04/2015 |