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General NPI Number Information
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NPI Number | 1114279239
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Entity Type | Individual
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Provider Name | BARBARA JANE THREATT GARVIN FNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 1 FREEDOM WAY (03)
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City | AUGUSTA
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State | GA
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Zip | 30904-6258
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Country | US
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Telephone | 706-733-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FREEDOM WAY # 3
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City | AUGUSTA
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State | GA
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Zip | 30904-6258
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Country | US
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Telephone | 706-733-0188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | FL 1726782
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 073367RN
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License Number State | GA
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