Provider Demographics
NPI:1356552749
Name:SSENJAKKO, JULIET ETHEL (MSN FNP)
Entity type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:ETHEL
Last Name:SSENJAKKO
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CLAYSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31216-5287
Mailing Address - Country:US
Mailing Address - Phone:478-714-4970
Mailing Address - Fax:229-228-4708
Practice Address - Street 1:205 CLAYSTONE CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-5287
Practice Address - Country:US
Practice Address - Phone:478-471-7794
Practice Address - Fax:478-471-7794
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily