| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JESSICA LOGUE | 1124645981 | 2020-07-22 |
Jessica Danielle Logue [F] graduated in 2020 and primarily specializes in Nurse Practitioner.
Jessica Logue is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1124645981. Registration indicates Jessica Logue is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse: Maternal Newborn, ) (Registered Nurse Maternal Newborn, Nursing Service Providers) (Registered Nurse, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 3476978008 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Jessica Logue |
| Practice Office Address | 791 POPLAR ST MACON, GA US |
| Practice Office Telephone | 4787558838 |
| Mailing Address | 791 POPLAR ST MACON, GA 312012045 US |
| Business Telephone | 4787558838 |
| Code | Practice | License No State |
|---|---|---|
| 163WM0102X | Nursing Service Providers Registered Nurse Registered Nurse: Maternal Newborn Registered Nurse Maternal Newborn Nursing Service Providers Registered Nurse | RN258772
GA |
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | RN258772
GA |