Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN197326 | GA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN197326 | GA |
N | 363LP2300X | Nurse Practitioner - Primary Care | RN197326 | GA |
NPI | 1083376271 |
---|---|
Provider Name | Jill Hooks |
First Address | Vidalia, GA 30474-8265 |
Second Address | Swainsboro, GA 30401-4818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2021 |
Last Update Date | 06/10/2021 |