Provider Demographics
NPI:1861680894
Name:AARON, JESSICA B (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:B
Last Name:AARON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-2036
Mailing Address - Country:US
Mailing Address - Phone:912-564-2182
Mailing Address - Fax:
Practice Address - Street 1:416 PINE ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:GA
Practice Address - Zip Code:30467-2036
Practice Address - Country:US
Practice Address - Phone:912-564-2182
Practice Address - Fax:912-564-7887
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN174545163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse