Healthcare Provider Details

I. General information

NPI: 1073340303
Provider Name (Legal Business Name): JULIA BREANNE GARREN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1348 WALTON WAY STE 4100
AUGUSTA GA
30901-5107
US

IV. Provider business mailing address

1348 WALTON WAY STE 4100
AUGUSTA GA
30901-5107
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-1381
  • Fax: 706-823-6871
Mailing address:
  • Phone: 706-722-1381
  • Fax: 706-823-6871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: