Healthcare Provider Details

I. General information

NPI: 1568178994
Provider Name (Legal Business Name): BRIGITTE LOCKE JARRARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 TIFT AVE N STE D
TIFTON GA
31794-3579
US

IV. Provider business mailing address

1909 US HIGHWAY 82 W STE 5
TIFTON GA
31793-8213
US

V. Phone/Fax

Practice location:
  • Phone: 229-382-5554
  • Fax:
Mailing address:
  • Phone: 229-386-4300
  • Fax: 229-386-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP268049
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: