Provider Demographics
NPI:1881265494
Name:REECE, JENNIFER (FNPBC APRN CDCES)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:REECE
Suffix:
Gender:F
Credentials:FNPBC APRN CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 CUMMINGS RD
Mailing Address - Street 2:
Mailing Address - City:TRION
Mailing Address - State:GA
Mailing Address - Zip Code:30753-5510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 LAVENDER DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2262
Practice Address - Country:US
Practice Address - Phone:877-365-0051
Practice Address - Fax:877-908-2523
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA223856163WD0400X, 207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine