Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACQUIECE LIDDELL, AGACNP
Active Sole ProprietorJACQUIECE LIDDELL, AGACNP is a Acute Care Nurse Practitioner healthcare provider located in ELLENWOOD, Georgia. NPI 1467988543 is currently active in the NPPES registry. Verify at CMS.
Acute Care Nurse Practitioner · ELLENWOOD, GA
Registration Details
- NPI Number
- 1467988543
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 10, 2017 (9.2536871854411 yrs)
- Last Updated
- Nov 8, 2025
- License
-
RN206975 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4357 BOXWOOD TRLELLENWOOD, GA, 302946518Browse GA providers · Browse ZIP 30294
- Phone
- 6785177897
- Primary Specialty
-
Acute Care Nurse Practitioner
363LA2100X
Other Acute Care Nurse Practitioner Providers in ELLENWOOD, GA
| Name | Credential | NPI |
|---|---|---|
| GWENDOLYN ELAINE MONTGOMERY | NURSE PRACTITIONER | 1629635859 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.