Provider Demographics
NPI:1508310228
Name:MAXWELL, JANET SMITH (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:SMITH
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 DANTIGNAC ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2775
Mailing Address - Country:US
Mailing Address - Phone:706-774-7760
Mailing Address - Fax:706-774-7766
Practice Address - Street 1:1303 DANTIGNAC ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2775
Practice Address - Country:US
Practice Address - Phone:706-774-7760
Practice Address - Fax:706-774-7766
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN081834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily