Provider Demographics
NPI:1841246691
Name:MCAFEE, JESSICA (PA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:MCAFEE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 HIGHWAY 54 W
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-2114
Mailing Address - Country:US
Mailing Address - Phone:770-716-0051
Mailing Address - Fax:770-716-0087
Practice Address - Street 1:1255 HWY 54 WEST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:770-716-0051
Practice Address - Fax:770-716-0087
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004645363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003120547AMedicaid
GA202I972013Medicare PIN
GA003120547AMedicaid