Healthcare Provider Details

I. General information

NPI: 1851782411
Provider Name (Legal Business Name): JO ANN SAXON AG-ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N HOUSTON RD
WARNER ROBINS GA
31093-2101
US

IV. Provider business mailing address

707 N HOUSTON RD
WARNER ROBINS GA
31093-2101
US

V. Phone/Fax

Practice location:
  • Phone: 478-922-4010
  • Fax: 478-922-2821
Mailing address:
  • Phone: 478-922-4010
  • Fax: 478-922-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN113335
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: