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

Juaquasha Hackley

Individual provider Women's Health Nurse Practitioner · NPI 1801650668

Juaquasha Hackley is a Nurse Practitioner in Dublin, Georgia. Qualified in 2024, 2 years ago. Practices with Providence OBGYN LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024

Practice location Address checks out

206 Fairview Park Dr
Dublin, GA 31021-2547
Phone: (478) 246-4304
Show map & directions

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

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence RN215651 (GA)

Record details

NPI number1801650668
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 12, 2024
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025
Mailing address206 Fairview Park Dr, Dublin, GA 31021-2547

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Providence Obgyn Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare