Healthcare Provider Details

I. General information

NPI: 1720632268
Provider Name (Legal Business Name): JOYCELYN WARREN REEVES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOYCELYN WARREN FNP

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 COHEN WALKER DRIVE
WARNER ROBINS GA
31088
US

IV. Provider business mailing address

P.O. BOX 293
JEFFERSONVILLE GA
31044
US

V. Phone/Fax

Practice location:
  • Phone: 478-218-2000
  • Fax:
Mailing address:
  • Phone: 478-945-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number250619
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: