Healthcare Provider Details

I. General information

NPI: 1982913729
Provider Name (Legal Business Name): JESSICA APRIL GARNER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA APRIL DAVIS CRNP

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 3RD AVE SE
MAGEE MS
39111-3665
US

IV. Provider business mailing address

300 3RD AVE SE
MAGEE MS
39111-3665
US

V. Phone/Fax

Practice location:
  • Phone: 601-849-5070
  • Fax: 601-849-0626
Mailing address:
  • Phone: 601-849-5070
  • Fax: 601-849-0626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR850991
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: