Healthcare Provider Details

I. General information

NPI: 1558820191
Provider Name (Legal Business Name): JORDAN MCKINNEY BARWICK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2806 HILLCREEK DR
AUGUSTA GA
30909-6484
US

IV. Provider business mailing address

111 SHADY OAK CT
WAYNESBORO GA
30830-6485
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-0200
  • Fax:
Mailing address:
  • Phone: 304-549-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP323686
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: