Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | RN222136 | GA |
NPI | 1376080515 |
---|---|
Provider Name | Mrs. Jessica Burns |
First Address | Tallahassee, FL 32312-3650 |
Second Address | Thomasville, GA 31792-6614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2017 |
Last Update Date | 27/09/2017 |