Provider Demographics
NPI:1700430857
Name:LEDGSITER, JAMECIA DARCIA (CLC, CNA)
Entity Type:Individual
Prefix:
First Name:JAMECIA
Middle Name:DARCIA
Last Name:LEDGSITER
Suffix:
Gender:F
Credentials:CLC, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 CEN OLY PK DR NW UNIT 1530
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30313-1956
Mailing Address - Country:US
Mailing Address - Phone:833-460-0121
Mailing Address - Fax:
Practice Address - Street 1:325 CEN OLY PK DR NW UNIT 1530
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-1956
Practice Address - Country:US
Practice Address - Phone:833-460-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAALPP-257356174N00000X
GACN0030027421376K00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No376K00000XNursing Service Related ProvidersNurse's Aide