JACQUELYN HUDAK BRANTLY (NPI# 1720329154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720329154 |
| Entity Type | Individual |
| Full Name | JACQUELYN HUDAK BRANTLY |
| Other Name | JACQUELYN NICOLE HUDAK |
| Credential | MMSC |
| Practice Address |
235 Peachtree St Ne North Tower, Suite 2100 Atlanta GA 30303-1401 |
| Mailing Address |
3112 Alston Dr Decatur GA 30032-3301 |
| Practice Telephone | 7709949326 |
| Mailing Telephone | 7708338386 |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2013-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 006743 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
235 PEACHTREE ST NE NORTH TOWER, SUITE 2100 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30303-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164480869 | Emerginet, LLC | Emergency Medicine | 235 Peachtree St Ne, North Tower, Suite 2100, Atlanta, GA 30303-1401 | 2006-05-02 |
| 1093267312 | Rena Jenkins | Non-emergency Medical Transport (VAN) | 235 Peachtree St Ne, Suite 400, Atlanta, GA 30303-1401 | 2016-11-03 |
| 1629523352 | Stephanie Thompson | Nurse Practitioner | 235 Peachtree St Ne, North Tower, Suite 2100, Atlanta, GA 30303-1401 | 2016-08-23 |
| 1326490384 | Theresa Ann Groves | Nurse Practitioner | 235 Peachtree St Ne, Suite 2100, North Tower, Atlanta, GA 30303-1401 | 2016-07-01 |
| 1487014403 | Jonathan Victor Iskaros | Physician Assistant | 235 Peachtree St Ne, North Tower, Suite 2100, Atlanta, GA 30303-1401 | 2016-03-03 |
| 1699144709 | Christiana Diane Jones | Nurse Practitioner | 235 Peachtree St Ne, North Tower, Suite 2100, Atlanta, GA 30303-1401 | 2015-09-18 |
| 1881078772 | Mitchell Aaron Busch | Physician Assistant | 235 Peachtree St Ne, Suite #2100, Atlanta, GA 30303-1401 | 2015-07-10 |
| 1942680863 | Amy Collier | Physician Assistant | 235 Peachtree St Ne, North Tower, Suite 2100, Atlanta, GA 30303-1401 | 2015-06-05 |
| 1457746703 | Fabiola Nneka Panchetti | Physician Assistant | 235 Peachtree St Ne, #2100, Atlanta, GA 30303-1401 | 2015-04-03 |
| 1922412022 | Hannah Folds | Nurse Practitioner | 235 Peachtree St Ne, Suite 2100, Atlanta, GA 30303-1401 | 2014-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
| 1952917155 | Alesha Deshay Elbert | Behavior Technician | 206 Peachstreet Ne Suite 2200, Atlanta, GA 30303 | 2020-09-22 |
| 1033759386 | Mark Bush | Case Manager/Care Coordinator | 50 Hurt Plaza Se Suite 1108, Atlanta, GA 30303 | 2020-01-14 |
| 1053965855 | Patrice Munsel Henry | Nurse Practitioner | 80 Jessie Hill Drive Se, Atlanta, GA 30303 | 2019-07-30 |
| 1356826564 | United States Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 260 Peachtree Street Nw, Suite 2200, Office 2228, Atlanta, GA 30303 | 2018-10-03 |
| 1336645290 | Joseph Bahng | Student in an Organized Health Care Education/Training Program | 69 Jesse Hill Jr Drive Se, Glenn Building, 4th Floor - 412b, Atlanta, GA 30303 | 2018-03-31 |
| 1841704707 | Amber Peach LLC | Family Medicine | 260 Peachtree St Nw Suite 2200, Atlanta, GA 30303 | 2017-11-29 |
| 1447778089 | Jasmine Williams | Behavioral Analyst | 260 Peachtree Street Nw, Suite 2200, Atlanta, GA 30303 | 2017-09-05 |
| 1982138236 | Mahek Dossani | Behavior Technician | 260 Peachtree Street Nw, Suite 2200, Atlanta, GA 30303 | 2017-04-13 |
| 1255872420 | Alexis Annick Auger | Behavior Technician | 260 Peachtree St. Nw, Suite 2200, Atlanta, GA 30303 | 2017-03-20 |
| Find all providers in zip 30303 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659970408 | Laura N Gillespie | Physician Assistant | 1800 Howell Mill Rd., Suite 450, Atlanta, GA 30318 | 2020-10-22 |
| 1104433689 | Alexander Hartley Sprague | Physician Assistant | 244 13th St Ne Apt 208, Atlanta, GA 30309-3656 | 2020-09-28 |
| 1972117919 | Gregory Zimmerman | Physician Assistant | 2669 Fleur De Lis Pl, Atlanta, GA 30360-1409 | 2020-09-08 |
| 1083227821 | Jessica Haley Senft | Physician Assistant | 4274 Olde Mill Ln Ne, Atlanta, GA 30342-3400 | 2020-08-30 |
| 1801405758 | Philip Sangster | Physician Assistant | 3485 Greystone Cir, Atlanta, GA 30341-5854 | 2020-07-27 |
| 1114544525 | Nicole Warner | Physician Assistant | 1100 Faith Ave Se, Atlanta, GA 30316-1504 | 2020-07-01 |
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1972125557 | Karen Charisse Forbes | Physician Assistant | 1600 Clifton Rd Ne # H16-1, Atlanta, GA 30329-4018 | 2020-05-17 |
| 1588290316 | Julie Teresa Lovelly | Physician Assistant | 1220 Caroline St Ne Ste A-230, Atlanta, GA 30307-2749 | 2020-03-12 |
| 1104463645 | Hannah Elyse Galvan | Physician Assistant | 550 Peachtree St Ne Bldg Rm3245a, Atlanta, GA 30308-2247 | 2019-12-03 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.