Provider Demographics
NPI:1730496571
Name:MILLARD, JENNIFER LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LOUISE
Last Name:MILLARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:NAJJAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4430 FALLOWFIELD LN SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-7402
Mailing Address - Country:US
Mailing Address - Phone:404-630-6878
Mailing Address - Fax:
Practice Address - Street 1:4430 FALLOWFIELD LN SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-7402
Practice Address - Country:US
Practice Address - Phone:404-630-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0340262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry