Provider Demographics
NPI:1790314524
Name:ERRATO, JENIKA JADE (FNP)
Entity Type:Individual
Prefix:
First Name:JENIKA
Middle Name:JADE
Last Name:ERRATO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TIMBER TRAIL RD
Mailing Address - Street 2:STE 104
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-9416
Mailing Address - Country:US
Mailing Address - Phone:860-754-6038
Mailing Address - Fax:
Practice Address - Street 1:100 TIMBER TRAIL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-9415
Practice Address - Country:US
Practice Address - Phone:912-445-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN272236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily