Healthcare Provider Details

I. General information

NPI: 1114670254
Provider Name (Legal Business Name): HANNAH JEAN CAMPBELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH REYNOLDS

II. Dates (important events)

Enumeration Date: 01/29/2022
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 WHEELER RD
AUGUSTA GA
30909-6521
US

IV. Provider business mailing address

4117 PULLMAN CIR
AUGUSTA GA
30909-9854
US

V. Phone/Fax

Practice location:
  • Phone: 706-651-3232
  • Fax:
Mailing address:
  • Phone: 478-832-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP248804
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: