Jade Asante-Selby, NP-C

Individual provider Active NPI Family Nurse Practitioner · Dacula, GA

NPI 1851908446 · NPPES record last updated Aug 23, 2021

Key facts

NPI
1851908446
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN271129 (GA)
Practice address
3027 Jim Moore Rd
Dacula, GA 30019-1144
Phone
(770) 339-0129
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN271129GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green Willow Pediatrics Past
since Oct 1, 2020
Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN271129 GA Yes

Addresses

Primary practice location

3027 Jim Moore Rd
Dacula, GA 30019-1144

Mailing address

3027 Jim Moore Rd
Dacula, GA 30019-1144
Phone (770) 339-0129

Other practice location 1

3030 McEver Rd Ste 130
Gainesville, GA 30504-5538
Phone (678) 450-0747

Other providers in Dacula, GA

All providers in Dacula, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.