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MRS. KRISTAL LYNNE JASTER PA-C

>> Dental Hygienist >> Dental Providers

Registrant NPI Number: 1689768673

Individual Registrant:
MRS. KRISTAL LYNNE JASTER PA-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
7306 GA HIGHWAY 21 STE 105  PORT WENTWORTH, GA 31407-9275 US
Tel: 912-966-2575  Fax: 912-966-0906

Contact information for business:
PO BOX 818  SPRINGFIELD, GA 31329-0818 US
Tel: --  Fax: 912-754-2570

Registration Information:
NPI: 1689768673
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N124Q00000XDental Providers
Dental Hygienist
NC6430
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
NC0010-04041
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
GA007452

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PHYSICIAN ASSISTANT LICENSE007452GA01




HEALTH CARE JOBS GA - Page 1



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