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

MS. Jacqueline Denise Ross, CRNP

Individual provider Primary Care Nurse Practitioner · NPI 1578118048

MS. Jacqueline Denise Ross, CRNP is a Nurse Practitioner in Fayetteville, Georgia. Qualified in 2019, 7 years ago. Practices with Privia Medical Group of Georgia LLC, a 450-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Licensed in
GA
In the registry since
2019
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

108 N Park Dr
Fayetteville, GA 30214-1645
Phone: (770) 487-7807
Show map & directions

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

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence RN323435 (GA)

Record details

NPI number1578118048
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedAugust 1, 2019
Last updated in NPPESFebruary 13, 2025
Certification dateFebruary 13, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Privia Medical Group Of Georgia Llc — 450 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fayetteville