Provider Demographics
NPI:1366697419
Name:ADKINS, JESSICA RITTIE (DNP, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RITTIE
Last Name:ADKINS
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 PAULSEN ST STE 312
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4426
Mailing Address - Country:US
Mailing Address - Phone:912-335-7712
Mailing Address - Fax:912-200-7971
Practice Address - Street 1:4849 PAULSEN ST STE 312
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-335-7712
Practice Address - Fax:912-200-7971
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168399363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1749Medicaid
GA003105298BMedicaid
GA003105298AMedicaid
GAP00915509OtherRR MEDICARE
GA583535OtherWELLCARE
GA202I502592Medicare PIN