Jessica Wilson

Individual provider Active NPI Case Manager/Care Coordinator · Manchester, GA

NPI 1619475480 · NPPES record last updated Jan 26, 2018

Key facts

NPI
1619475480
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
307 5TH St
Manchester, GA 31816-2020
Phone
(706) 741-7025
NPI assigned
Jan 26, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

307 5TH St
Manchester, GA 31816-2020

Mailing address

307 5TH St
Manchester, GA 31816-2020
Phone (706) 741-7025

Other providers in Manchester, GA

All providers in Manchester, GA · Case Manager/Care Coordinator in Georgia

Sources for this page

Verify at the official NPI Registry.