| Doctor Name: | JENNIFER MASCARIN |
| NPI Number: | 1003260720 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RNI88599 |
| Business Practice Address: | 1120 15th St Augusta, GA - 309120004 |
| Business Phone Number: | 7067215437 |
| Business Fax Number: | |
| Mailing Address: | 1499 Walton Way, Suite 1400 AUGUSTA |
| State: | GA |
| Postal Code: | 309012603 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2016 |
| NPI Last Update Date: | 04/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0222X |
| License Number: | RNI88599 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics, Critical Care |
| Taxonomy Definition: | |