MEDICARE: JENNIFER ASHLEY SKINNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN232787	GA

General Provider Information

NPI Number	:	1144957671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ASHLEY SKINNER

Provider Business Mailing Address
First Line	:	440 MALL BLVD STE C
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31406-4868
Country	:	US
Telephone Number	:	912-644-3340
Fax Number	:

Provider Business Practice Location Address
First Line	:	821 S MAIN ST STE C
Second Line	:
City	:	BAXLEY
State	:	GA
Zip	:	31513-0163
Country	:	US
Telephone Number	:	912-644-5300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	05/11/2026

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