Provider Demographics
NPI:1235180910
Name:WRENN, JANE COX (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:COX
Last Name:WRENN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-6004
Mailing Address - Country:US
Mailing Address - Phone:706-769-0000
Mailing Address - Fax:
Practice Address - Street 1:485 HIGHWAY 29 N
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-5583
Practice Address - Country:US
Practice Address - Phone:706-353-6000
Practice Address - Fax:706-353-2694
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN061080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
04/04/59OtherDATE OF BIRTH