Provider Demographics
NPI:1942390109
Name:HARRISON, JENNIFER F (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:F
Last Name:HARRISON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 436
Mailing Address - Street 2:50 HIGHWAY 56 NORTH
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-0436
Mailing Address - Country:US
Mailing Address - Phone:478-237-7501
Mailing Address - Fax:
Practice Address - Street 1:50 HIGHWAY 56 NORTH
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-4441
Practice Address - Country:US
Practice Address - Phone:478-237-7501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR157099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily