Healthcare Provider Details

I. General information

NPI: 1235951658
Provider Name (Legal Business Name): JENNIFER POLLARD BOONE RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E 68TH ST STE B
SAVANNAH GA
31405-4724
US

IV. Provider business mailing address

815 E 68TH ST STE B
SAVANNAH GA
31405-4724
US

V. Phone/Fax

Practice location:
  • Phone: 912-303-3500
  • Fax: 912-303-3509
Mailing address:
  • Phone: 912-303-3500
  • Fax: 912-303-3509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN-NP173801
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: