Provider Demographics
NPI:1902306780
Name:NAKIGUDDE, JACENT BARBARA (FNP)
Entity Type:Individual
Prefix:
First Name:JACENT
Middle Name:BARBARA
Last Name:NAKIGUDDE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 SILVERCREST CT
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6084
Mailing Address - Country:US
Mailing Address - Phone:912-224-2928
Mailing Address - Fax:
Practice Address - Street 1:3999 AUSTELL RD STE 901
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1160
Practice Address - Country:US
Practice Address - Phone:770-809-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-18
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN223000163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice