Doctor Name: | MRS. JENNY R JANNEY |
NPI Number: | 1053562538 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 4840 |
Business Practice Address: | 368 Northside Dr E Statesboro, GA - 304584839 |
Business Phone Number: | 9124896246 |
Business Fax Number: | 9124866346 |
Mailing Address: | 368 Northside Dr E, STATESBORO |
State: | GA |
Postal Code: | 304584839 |
Phone Number: | 9124896246 |
Fax Number: | 9124896346 |
NPI Enumeration Date: | 10/02/2008 |
NPI Last Update Date: | 10/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 4840 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |