Most Relevant Information
Provider Data
| NPI Number: | 1003699661 |
| Provider Name: | JASMAIN MACON FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 71015431A |
Most Important Dates
| Enumeration Date: | 08/17/2023 |
| Last Updated: | 10/16/2024 |
Provider Practice Location
6272 HICKORY LANE CIR
UNION CITY
GA
302915507
Practice Location Phone/Fax
| Phone: | 8039205895 |
| Fax: |
Provider Mailing Location
6272 HICKORY LANE CIR
UNION CITY
GA
302915507
Provider Mailing Phone/Fax
| Phone: | 8039205895 |
| Fax: |