Provider Demographics
NPI:1891331575
Name:BARNES CARON, JENNA (AGPCNPBC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BARNES CARON
Suffix:
Gender:F
Credentials:AGPCNPBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 MEMORIAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8664
Mailing Address - Country:US
Mailing Address - Phone:706-226-3139
Mailing Address - Fax:
Practice Address - Street 1:1107 MEMORIAL DR STE 300
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8664
Practice Address - Country:US
Practice Address - Phone:706-226-3139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN290465207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine