Provider Demographics
NPI:1710192109
Name:ADAMS, JENNIFER C (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:C
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4 JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-355-1010
Mailing Address - Fax:912-721-3092
Practice Address - Street 1:4 JACKSON BLVD.
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-355-1010
Practice Address - Fax:913-722-1309
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN157995363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner