Basic Information
| Provider Information | |||||||||
| NPI: | 1073277349 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGRIFF | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | DARLENE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 471 DENTON RD | ||||||||
| Address2: | |||||||||
| City: | CEDARTOWN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301254369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9063224251 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 304 TURNER MCCALL BLVD SW | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301655621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065095000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2021 | ||||||||
| LastUpdateDate: | 10/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN268622 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.