Jacquita Gresham, is a
Clinical Nurse Specialist - Home Health based in Covington, Georgia. Jacquita Gresham is licensed to practice in Georgia (license number 873976524) and her current practice location is
95 Stone Ridge Way, Covington, Georgia. She can be reached at her office (for appointments etc.) via phone at
(470) 621-5877.
NPI number for Jacquita Gresham is 1902538887 and her current mailing address is 95 Stone Ridge Way, Covington, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1902538887.
Provider's Profile
Full Name | Jacquita Gresham |
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Gender | Female |
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Speciality | Clinical Nurse Specialist - Home Health |
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Location | 95 Stone Ridge Way, Covington, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1902538887
- Provider Enumeration Date: 06/28/2022
- Last Update Date: 06/28/2022
Medical Identifiers
Medical identifiers for Jacquita Gresham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902538887 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
364SH0200X | Clinical Nurse Specialist - Home Health | 873976524 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquita Gresham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacquita Gresham, 95 Stone Ridge Way, Covington, GA 30016-6923 Ph: (470) 621-5877 | Jacquita Gresham, 95 Stone Ridge Way, Covington, GA 30016-6923 Ph: (470) 621-5877 |
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