Healthcare Provider Details

I. General information

NPI: 1265130306
Provider Name (Legal Business Name): JENNA THOMAS HARVEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 HILLCREST PKWY STE 1
DUBLIN GA
31021-4259
US

IV. Provider business mailing address

1406 S POPLAR SPRINGS CHURCH RD
DUBLIN GA
31021-8315
US

V. Phone/Fax

Practice location:
  • Phone: 478-272-8140
  • Fax:
Mailing address:
  • Phone: 229-315-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN288200
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN288200
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: