Provider Demographics
NPI:1598027740
Name:GIVENS, JAMIE BATTLE (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:BATTLE
Last Name:GIVENS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 S HOUSTON LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6300
Mailing Address - Country:US
Mailing Address - Phone:478-953-1020
Mailing Address - Fax:478-953-5406
Practice Address - Street 1:136 S HOUSTON LAKE RD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6300
Practice Address - Country:US
Practice Address - Phone:478-953-1020
Practice Address - Fax:478-953-5406
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6468363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6468OtherSTATE LICENSE