Jolly, Tina
Jolly, Tina is an individual health care provider with primary practice located at 107 Fairview Park Dr , Dublin GA 31021-2501. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jolly, Tina can be contacted via phone (478) 272-3446.Contact Information
Primary practice address
107 Fairview Park Dr
Dublin GA 31021-2501
Phone: (478) 272-3446
Fax: (478) 864-1288
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN139653 | Georgia |
Profile Details
| NPI number | 1619412004 |
|---|---|
| LBN Legal business name | Jolly, Tina |
| Credentials | MSN, APRN, NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2016 |
| Last updated | May 22nd, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619412004 | NPPES |
| North Carolina | MEDICAID | 1619412004 | |
| North Carolina | MEDICAID | Q071116 | |
| North Carolina | MEDICAID | 003151473D |
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