Provider Demographics
NPI:1699716043
Name:JUMP, ANDREA N (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:N
Last Name:JUMP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 HONEY CREEK COMMONS SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-5830
Mailing Address - Country:US
Mailing Address - Phone:770-922-2556
Mailing Address - Fax:678-210-0280
Practice Address - Street 1:1809 HONEY CREEK COMMONS SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5830
Practice Address - Country:US
Practice Address - Phone:770-922-2556
Practice Address - Fax:678-210-0280
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV07891Medicare UPIN
GA35ZCJMGMedicare ID - Type Unspecified