Provider Demographics
NPI:1699476721
Name:SINGLETON, JENNIFER C
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3068 JEFFERSONVILLE RD APT 9E
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-5168
Mailing Address - Country:US
Mailing Address - Phone:478-733-6413
Mailing Address - Fax:
Practice Address - Street 1:3068 JEFFERSONVILLE RD APT 9E
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-5168
Practice Address - Country:US
Practice Address - Phone:478-733-6413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049407892347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle