Mathis, Jessica Nicole

Mathis, Jessica Nicole is an individual health care provider with primary practice located at 132 Old Norton Rd Suite 200, Fayetteville GA 30215-4872. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Mathis, Jessica Nicole can be contacted via phone (678) 817-1117.

Contact Information

Primary practice address
132 Old Norton Rd Suite 200 Fayetteville GA 30215-4872
Phone: (678) 817-1117
Fax: (678) 817-0823
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN164716 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN164716 Georgia

Profile Details

NPI number 1235511338
LBN Legal business name Mathis, Jessica Nicole
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2015
Last updated Aug 19th, 2020 - about 6 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235511338 NPPES
Georgia MEDICAID 003169046B

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