Healthcare Provider Details

I. General information

NPI: 1427888346
Provider Name (Legal Business Name): JANUARY MICHELLE FLOYD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 E SHOTWELL ST
BAINBRIDGE GA
39819-4146
US

IV. Provider business mailing address

832 E SHOTWELL ST
BAINBRIDGE GA
39819-4146
US

V. Phone/Fax

Practice location:
  • Phone: 229-205-2954
  • Fax:
Mailing address:
  • Phone: 229-231-6146
  • Fax: 229-207-4127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN166717
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN166717
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: