Provider Demographics
NPI:1740584580
Name:TOLEDO, JODI HENDERSON (RN)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:HENDERSON
Last Name:TOLEDO
Suffix:
Gender:F
Credentials:RN
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Other - First Name:
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Mailing Address - Street 1:1800 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8416
Mailing Address - Country:US
Mailing Address - Phone:770-886-3555
Mailing Address - Fax:770-205-6501
Practice Address - Street 1:1800 NORTHSIDE FORSYTH DR
Practice Address - Street 2:SUITE 350
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8416
Practice Address - Country:US
Practice Address - Phone:770-886-3555
Practice Address - Fax:770-205-6501
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2015-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN154366163W00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse