Provider Demographics
NPI:1164066106
Name:FRANZ, JENNA RUBIN (FNP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:RUBIN
Last Name:FRANZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LAKE FRONT DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6017
Mailing Address - Country:US
Mailing Address - Phone:478-320-5327
Mailing Address - Fax:
Practice Address - Street 1:109 LAKE FRONT DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6017
Practice Address - Country:US
Practice Address - Phone:478-320-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN139647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily