Provider Demographics
NPI:1407381833
Name:GARNES, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MAPLE ST
Mailing Address - Street 2:APT 1
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23868-1420
Mailing Address - Country:US
Mailing Address - Phone:434-532-2214
Mailing Address - Fax:434-848-2409
Practice Address - Street 1:515 MAPLE ST
Practice Address - Street 2:APT 1
Practice Address - City:LAWRENCEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23868-1420
Practice Address - Country:US
Practice Address - Phone:434-532-2214
Practice Address - Fax:434-848-2409
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)