Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1235880634 Individual Practitioner Female Practitioner

Jessica Diane Membrillo , AGACNP-BC

Nurse Practitioner • Canton, GA

Professional Overview & Biography Verified Profile Summary

Jessica Membrillo, AGACNP-BC is a registered healthcare professional specializing in Nurse Practitioner in Canton, GA. Practice services are available at 145 RIVERSTONE TER STE 101 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

145 Riverstone Ter Ste 101

Canton, GA 301145327

Telephone 7704504807
Associated Practice Facility / Clinic
🏢 Nova Spine And Pain Care Pc Facility NPI 1225759236

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Canton, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.1 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
29 Specialists

Practicing in Canton, GA (3149 Statewide)

Telehealth Adoption Rate
13.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-09
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License GA RN259993

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Registered Nurse

NUCC Taxonomy Code: 163W00000X

State License GA RN259993

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Chitra Ramasubbu , MD

Anesthesiology - Pain Medicine

NPI 1467614016

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 09, 2025

Registered Nurse (License #RN259993 in GA)

📍
Updated Practice Location October 30, 2023

Registered at 145 RIVERSTONE TER STE 101, CANTON, GA 301145327 (Tel: 7704504807)

👤
Provider Name / Credentials Updated October 30, 2023

Recorded as JESSICA MEMBRILLO, AGACNP-BC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 30, 2023

Nurse Practitioner (License #RN259993 in GA)

👤
Provider Name / Credentials Updated June 23, 2023

Recorded as JESSICA MEMBRILLO, RN

NPI Profile Active January 17, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location January 17, 2022

Registered at 677 CHURCH ST NE, MARIETTA, GA 300601101 (Tel: 7707935000)

📍
Updated Business Mailing Address January 17, 2022

Registered at 606 FOREST PINE DR, BALL GROUND, GA 301075196 (Tel: 7706084407)

👤
Provider Name / Credentials Updated January 17, 2022

Recorded as JESSICA SMITH, RN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 17, 2022

Registered Nurse (License #RN259993 in GA)

🟢
Initial NPI Registration & Enumeration January 17, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235880634
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 17, 2022
Last Update: October 09, 2025
Sole Proprietor: Yes

Mailing Address

606 Forest Pine Dr

Ball Ground, GA 301075196

Phone: 7706084407

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.