Provider Demographics
NPI:1043033376
Name:JESSICA POE P.C.
Entity type:Organization
Organization Name:JESSICA POE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, NP
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, PMHNP-BC
Authorized Official - Phone:912-275-4763
Mailing Address - Street 1:3441 CYPRESS MILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-2879
Mailing Address - Country:US
Mailing Address - Phone:912-275-4763
Mailing Address - Fax:912-216-3668
Practice Address - Street 1:3441 CYPRESS MILL RD STE 101
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-2879
Practice Address - Country:US
Practice Address - Phone:912-275-4763
Practice Address - Fax:912-216-3668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty