Provider Demographics
NPI:1326408147
Name:RUMMEL, JENAVIEVE AVERYL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JENAVIEVE
Middle Name:AVERYL
Last Name:RUMMEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:531 ROSELANE ST NW STE 710
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:678-331-3297
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:100 MARKET PLACE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-8716
Practice Address - Country:US
Practice Address - Phone:770-386-7253
Practice Address - Fax:770-382-6424
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA008761363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1326408147OtherNPI NUMBER