Provider Demographics
NPI:1841534559
Name:HANEY, JAMES BEAUMONT (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BEAUMONT
Last Name:HANEY
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8811 HIGHWAY 92
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-6508
Mailing Address - Country:US
Mailing Address - Phone:678-592-8248
Mailing Address - Fax:678-324-6071
Practice Address - Street 1:8811 HIGHWAY 92
Practice Address - Street 2:SUITE 106
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6508
Practice Address - Country:US
Practice Address - Phone:678-592-8248
Practice Address - Fax:678-324-6071
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN135542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily