Provider Demographics
NPI:1316557697
Name:ESTERLING, JACQUELYN KELLY (MS, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JACQUELYN
Middle Name:KELLY
Last Name:ESTERLING
Suffix:
Gender:F
Credentials:MS, APRN, FNP-C
Other - Prefix:MS
Other - First Name:JACQUELYN
Other - Middle Name:JOAN
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3660 HOWELL FERRY RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3178
Mailing Address - Country:US
Mailing Address - Phone:770-670-4640
Mailing Address - Fax:770-670-4644
Practice Address - Street 1:3660 HOWELL FERRY RD BLDG B
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3178
Practice Address - Country:US
Practice Address - Phone:770-670-4640
Practice Address - Fax:770-460-4644
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily