Provider Demographics
NPI:1003142647
Name:MATTHEWS, JESSICA N (CNA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:N
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 CEDAR CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-4409
Mailing Address - Country:US
Mailing Address - Phone:770-655-4426
Mailing Address - Fax:
Practice Address - Street 1:751 CEDAR CREEK RD NW
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-4409
Practice Address - Country:US
Practice Address - Phone:770-655-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-01
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0028865250376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide