Provider Demographics
NPI:1609446590
Name:FILER, JENNIFER DUDLEY (NP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DUDLEY
Last Name:FILER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 DALLAS HWY SW STE 340
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-7518
Mailing Address - Country:US
Mailing Address - Phone:678-797-9800
Mailing Address - Fax:678-797-9801
Practice Address - Street 1:2655 DALLAS HWY SW STE 340
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-7518
Practice Address - Country:US
Practice Address - Phone:678-797-9800
Practice Address - Fax:678-797-9801
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty