Provider Demographics
NPI:1477027415
Name:JARRETTE, GREGORY (ARNP)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:JARRETTE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 SADDLE CHASE DR
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-5411
Mailing Address - Country:US
Mailing Address - Phone:904-263-6821
Mailing Address - Fax:
Practice Address - Street 1:5885 GLENRIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5572
Practice Address - Country:US
Practice Address - Phone:678-321-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-13
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN21968363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty