Doctor Name: | MS. MARTHA JEANNETTE JOLLEY |
NPI Number: | 1710048798 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | 404415 |
Business Practice Address: | 220 California Dr Yountville, CA - 945991412 |
Business Phone Number: | 7079444716 |
Business Fax Number: | |
Mailing Address: | 220 California Dr, YOUNTVILLE |
State: | CA |
Postal Code: | 945991412 |
Phone Number: | 7079444716 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 03/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 404415 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |