Provider Demographics
NPI:1801373493
Name:BACHE, JESSICA BROOKE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BROOKE
Last Name:BACHE
Suffix:
Gender:F
Credentials:FNP-C
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Mailing Address - Street 1:1835 SAVOY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1071
Mailing Address - Country:US
Mailing Address - Phone:770-496-9430
Mailing Address - Fax:404-891-4947
Practice Address - Street 1:624 W MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2787
Practice Address - Country:US
Practice Address - Phone:478-453-1806
Practice Address - Fax:478-453-1807
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2023-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN245340363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner