Provider Demographics
NPI:1720869472
Name:SON, JIA (NP-BC)
Entity type:Individual
Prefix:
First Name:JIA
Middle Name:
Last Name:SON
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0016
Mailing Address - Fax:
Practice Address - Street 1:7710 MCGINNIS FERRY RD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1622
Practice Address - Country:US
Practice Address - Phone:770-268-4361
Practice Address - Fax:470-251-6068
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN261604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily