Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessica Diane Membrillo, AGACNP-BC

Individual provider Registered Nurse · NPI 1235880634

Jessica Diane Membrillo, AGACNP-BC is a Registered Nurse in Canton, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2022
Specialties on file
2

Practice location Address checks out

145 Riverstone Ter Ste 101
Canton, GA 30114-5327
Phone: (770) 450-4807
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN259993 (GA)
Registered Nurse Taxonomy 163W00000X · Licence RN259993 (GA)

Record details

NPI number1235880634
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorYes
NPI enumeratedJanuary 17, 2022
Last updated in NPPESOctober 9, 2025
Certification dateOctober 9, 2025

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