Provider Demographics
NPI:1265130306
Name:HARVEY, JENNA THOMAS (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:THOMAS
Last Name:HARVEY
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 1:1406 S POPLAR SPRINGS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-8315
Mailing Address - Country:US
Mailing Address - Phone:229-315-8038
Mailing Address - Fax:
Practice Address - Street 1:1006 HILLCREST PKWY STE 1
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4259
Practice Address - Country:US
Practice Address - Phone:478-272-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN288200163W00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse