Provider Demographics
NPI:1851986541
Name:DOLAN, JODY LYNN (APRN, PNP-PC)
Entity Type:Individual
Prefix:MISS
First Name:JODY
Middle Name:LYNN
Last Name:DOLAN
Suffix:
Gender:F
Credentials:APRN, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 HANNAHS MILL RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-2801
Mailing Address - Country:US
Mailing Address - Phone:706-938-0990
Mailing Address - Fax:706-647-3861
Practice Address - Street 1:210 HANNAHS MILL RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-2801
Practice Address - Country:US
Practice Address - Phone:706-938-0990
Practice Address - Fax:706-647-3861
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN201257208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics