Provider Demographics
NPI:1770294407
Name:DAWSON, JASMINE LOVING (FNP-C)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:LOVING
Last Name:DAWSON
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 1:4966 BENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-9020
Mailing Address - Country:US
Mailing Address - Phone:229-563-2696
Mailing Address - Fax:
Practice Address - Street 1:520 GRIFFIN AVE
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-6331
Practice Address - Country:US
Practice Address - Phone:229-433-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN233008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily