Provider Demographics
NPI:1477097319
Name:IRIONS, AUTUMN JOY
Entity Type:Individual
Prefix:MS
First Name:AUTUMN
Middle Name:JOY
Last Name:IRIONS
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 1:107 RED FOX CT
Mailing Address - Street 2:
Mailing Address - City:CATAULA
Mailing Address - State:GA
Mailing Address - Zip Code:31804-4488
Mailing Address - Country:US
Mailing Address - Phone:706-577-1354
Mailing Address - Fax:
Practice Address - Street 1:107 RED FOX CT
Practice Address - Street 2:
Practice Address - City:CATAULA
Practice Address - State:GA
Practice Address - Zip Code:31804-4488
Practice Address - Country:US
Practice Address - Phone:706-577-1354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN234596363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner