Jodi Mcconnell, | |
115 Lathems Mill Ln, Ball Ground, GA 30107-7906 | |
(678) 595-7227 | |
Not Available |
Full Name | Jodi Mcconnell |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 115 Lathems Mill Ln, Ball Ground, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780182725 | NPI | - | NPPES |
RN122137 | Other | GA | ADVANCED PRACTICE-NP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | RN122137 (Georgia) | Primary |
Entity Name | Northside Surgical Professional Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356630990 PECOS PAC ID: 8628253424 Enrollment ID: O20110420000598 |
Mailing Address | Practice Location Address |
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Jodi Mcconnell, 115 Lathems Mill Ln, Ball Ground, GA 30107-7906 Ph: () - | Jodi Mcconnell, 115 Lathems Mill Ln, Ball Ground, GA 30107-7906 Ph: (678) 595-7227 |
Dorene Ebangha Etarock, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8111 Ball Ground Hwy, Ball Ground, GA 30107 Phone: 770-268-4011 | |
Sonya Mabry, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8111 Ball Ground Hwy, Ball Ground, GA 30107 Phone: 770-268-4011 | |
Mrs. Janice Denise Reed, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 470 Valley St Ste 200, Ball Ground, GA 30107 Phone: 770-737-2770 Fax: 770-737-2406 |