Jacquelyn Hairston, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN299265 Issued in GA

Practice address

297 Cooper Rd
Loganville, GA 30052-2518

Phone

(678) 381-2630

NPI assigned

Sep 26, 2023

Last updated

Sep 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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

• Grayson Pediatrics, LLC

  • Pediatrics Physician
  • Loganville, GA
  • NPI 1831500370
  NPD
• Grayson Pediatrics, LLC

  • Pediatrics Physician
  • Grayson, GA
  • NPI 1083026066
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1972382240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 COOPER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 COOPER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522518",
            "telephone_number": "678-381-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRSTON",
        "first_name": "JACQUELYN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN299265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Phelps Gulsby, NP-C
• Omotayo Guthrie
• Gwinnett Clinic, LTD
• Georgette A Gyamfi, RN
• Corina J Hagood
• Katherine Hamil, PT, DPT
• Schonie L Hamilton
• Susan Hammond, BA OTR
• Brittany Hanberry, MHSOT, OTR/L, CBIS
• Fernando Gorca Hancock R Donaldson

• Registered Nurse in Loganville, GA
• Providers in Loganville, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.