Provider Demographics
NPI:1003388273
Name:BOONE, JANET (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-6112
Mailing Address - Country:US
Mailing Address - Phone:229-868-2106
Mailing Address - Fax:229-868-2107
Practice Address - Street 1:23 W MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:MC RAE HELENA
Practice Address - State:GA
Practice Address - Zip Code:31055-4150
Practice Address - Country:US
Practice Address - Phone:229-868-2106
Practice Address - Fax:229-868-2107
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF10181653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily