Provider Demographics
NPI:1447548698
Name:CAUDELL, JASON DANIEL (NP-C)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:DANIEL
Last Name:CAUDELL
Suffix:
Gender:M
Credentials:NP-C
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Mailing Address - Street 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0116
Mailing Address - Fax:
Practice Address - Street 1:204 DAWSON VILLAGE WAY S
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-5629
Practice Address - Country:US
Practice Address - Phone:770-268-4360
Practice Address - Fax:470-251-6066
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2025-07-31
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Provider Licenses
StateLicense IDTaxonomies
MECNP161095363LF0000X
GARN154971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily