| Doctor Name: | MR. JESSE MCKINNON |
| NPI Number: | 1407219314 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | RN204966 |
| Business Practice Address: | 267 N Harrington Rd St Simons Island, GA - 315225341 |
| Business Phone Number: | 9122300030 |
| Business Fax Number: | 9126340959 |
| Mailing Address: | 3950 Ga Highway 64 E, AXSON |
| State: | GA |
| Postal Code: | 316242032 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/30/2016 |
| NPI Last Update Date: | 03/30/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN204966 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |