Jahid Kwaku Ross, Nurse Practitioner

Nurse Practitioner, Family in Lawrenceville, GA. Individual provider (NPI-1).

NPI number1013590280

StatusActive

Last updated in NPPESJun 6, 2023

Details

NPI: 1013590280
Entity type: Individual (NPI-1)
Name: Mr. Jahid Kwaku Ross
Credential: Nurse Practitioner
Sex: Male
Sole proprietor: No
Enumeration date: May 4, 2021
Certification date: Apr 6, 2023
Last updated: Jun 6, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	95025461	CA	Yes
163W00000X	Registered Nurse	95178036	CA
163W00000X	Registered Nurse	10.173173	CT
163WM0705X	Registered Nurse, Medical-Surgical	296511	NC
163WP0807X	Registered Nurse, Psych/Mental Health, Child & Adolescent	296511	NC

Other names

Jahid Kwaku Ross (Professional Name)

Practice location

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Phone 404-209-2394

Mailing address

2816 Raleigh Ave
Winston Salem, NC 27105-4734

Phone 336-986-4623

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