SAVANNAH BRYANNA JACKSON (NPI# 1558876524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558876524 |
Entity Type | Individual |
Full Name | SAVANNAH BRYANNA JACKSON |
Credential | NP |
Practice Address |
100 Professional Pl Ste 204 Carrollton GA 30117-3802 |
Mailing Address |
100 Professional Park Suite 204 Carrollton GA 30117 |
Practice Telephone | 7708343351 |
Enumeration Date | 2017-12-12 |
Last Update Date | 2018-02-20 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN222275 | GA | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700347515 | Savannah Leigh Jackson | Occupational Therapist | 222 Ladean Ct Ste E, Simpsonville, SC 29680-7504 | 2019-03-26 |
Street Address |
100 PROFESSIONAL PL STE 204 |
City | CARROLLTON |
State | GA |
Zip Code | 30117-3802 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053453787 | Pinnacle Orthopaedics and Sports Medicine | Specialist | 100 Professional Pl Ste 204, Carrollton, GA 30117-3802 | 2007-02-12 |
1487153839 | Lauren Holcombe | Nurse Practitioner | 100 Professional Pl Ste 204, Carrollton, GA 30117 | 2018-02-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
Find all providers in zip 30117 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194203851 | Laura Marie Fessler | Nurse Practitioner | 2300 Marsh Ln Apt 214, Carrollton, TX 75006-4852 | 2018-08-03 |
1417458498 | Larrice Tela Gorley | Nurse Practitioner | 174 Emerald Pointe Dr, Carrollton, GA 30116-9409 | 2018-02-23 |
1851733679 | Angela M Rogers | Nurse Practitioner | 100 Professional Pl Ste 310, Carrollton, GA 30117-3872 | 2013-07-22 |
1326676206 | Jessica Danielle Spears | Nurse Practitioner | 4343 N Josey Ln, Carrollton, TX 75010-4603 | 2020-03-27 |
1659907160 | Angelita Ancheta Parrish | Nurse Practitioner | 2340 E Trinity Mills Rd Ste 250, Carrollton, TX 75006-1946 | 2020-03-16 |
1780043463 | Michael John Sullivan | Nurse Practitioner | 705 Dixie St, Suite 401, Carrollton, GA 30117-3818 | 2016-02-23 |
1689045957 | Kelsey Elizabeth Reekie | Nurse Practitioner | 4240 International Pkwy, Suite 154, Carrollton, TX 75007-1970 | 2015-10-13 |
1588079248 | Emily Tarpley Massey | Nurse Practitioner | 157 Clinic Ave Ste 203, Carrollton, GA 30117-4454 | 2014-06-20 |
1093956351 | Melanie Sims | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2009-03-17 |
1881818854 | Tracy Lynn Brown | Nurse Practitioner | 4325 N Josey Ln, Plaza 2 Suite 301, Carrollton, TX 75010-4635 | 2007-04-12 |
Find all providers in CARROLLTON |
City | CARROLLTON |
Zip Code | 30117 |
Please comment or provide details below to improve the information on SAVANNAH BRYANNA JACKSON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.