Healthcare Provider Details

I. General information

NPI: 1326491663
Provider Name (Legal Business Name): JENNIFER CLINE TAUNTON MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SMITH ST
LAGRANGE GA
30240-2745
US

IV. Provider business mailing address

548 WILLOWOOD RD
LAGRANGE GA
30241-8166
US

V. Phone/Fax

Practice location:
  • Phone: 706-882-8831
  • Fax:
Mailing address:
  • Phone: 706-594-2581
  • Fax: 706-812-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN215191
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: