Provider Demographics
NPI:1457169849
Name:MARMOLEJOS, JESSICA E
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:MARMOLEJOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4634 FINDLEY DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-1243
Mailing Address - Country:US
Mailing Address - Phone:678-939-2410
Mailing Address - Fax:
Practice Address - Street 1:4634 FINDLEY DR
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-1243
Practice Address - Country:US
Practice Address - Phone:678-939-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula