Provider Demographics
NPI:1821975350
Name:ATKINS, JACKSON (FNP)
Entity type:Individual
Prefix:
First Name:JACKSON
Middle Name:
Last Name:ATKINS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 SEDGEFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-5860
Mailing Address - Country:US
Mailing Address - Phone:404-884-3854
Mailing Address - Fax:
Practice Address - Street 1:210 OAK ST N
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5139
Practice Address - Country:US
Practice Address - Phone:706-855-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN280175208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice