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General NPI Number Information
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NPI Number | 1205277993
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Entity Type | Individual
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Provider Name | BRANDI JACKSON SWATTS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 100 HIGHWAY 18 W STE 106
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City | BARNESVILLE
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State | GA
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Zip | 30204-1198
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Country | US
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Telephone | 770-358-3284
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Fax | 770-358-1015
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Provider Business Mailing Address
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Address Line | PO BOX 589
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City | THOMASTON
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State | GA
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Zip | 30286-0008
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Country | US
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Telephone | 770-358-3284
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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 | RN190818
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License Number State | GA
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