Mrs Stephanie Brazeal Jackson, NP | |
711 Trestle Rd, Locust Grove, GA 30248-3465 | |
(770) 914-5934 | |
Not Available |
Full Name | Mrs Stephanie Brazeal Jackson |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 711 Trestle Rd, Locust Grove, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255512984 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | RN071218 (Georgia) | Primary |
Entity Name | Piedmont Hospitalist Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548219660 PECOS PAC ID: 1951299163 Enrollment ID: O20040309000820 |
Entity Name | Coweta Emergency Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245556588 PECOS PAC ID: 5395876452 Enrollment ID: O20100706000634 |
Entity Name | Georgia Emergency Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952746638 PECOS PAC ID: 4082853262 Enrollment ID: O20130619000316 |
Mailing Address | Practice Location Address |
---|---|
Mrs Stephanie Brazeal Jackson, NP 711 Trestle Rd, Locust Grove, GA 30248-3465 Ph: (770) 914-5934 | Mrs Stephanie Brazeal Jackson, NP 711 Trestle Rd, Locust Grove, GA 30248-3465 Ph: (770) 914-5934 |
Bridgette G Williams, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1201 Nottley Dr, Locust Grove, GA 30248 Phone: 770-597-7739 | |
Florence Achilihu Adiele, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5293 Heron Bay Blvd, Locust Grove, GA 30248 Phone: 706-769-7658 | |
Chavonn Done Davidson-smith, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3000 Norwell Ct, Locust Grove, GA 30248 Phone: 770-634-7470 | |
Michelle Denise Bush, RN, MSN, CRNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3758 Highway 42, Locust Grove, GA 30248 Phone: 678-561-9430 Fax: 770-914-1070 | |
Amanda Faye Tison, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4837 Bill Gardner Pkwy Ste B, Locust Grove, GA 30248 Phone: 678-800-1602 | |
Linda Faulkner, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4861 Bill Gardner Pkwy, Suite 100, Locust Grove, GA 30248 Phone: 770-626-5740 Fax: 770-626-5750 |