=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558820191
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JORDAN MCKINNEY BARWICK FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2019
-----------------------------------------------------
Last Update Date | 05/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2806 HILLCREEK DR
-----------------------------------------------------
City | AUGUSTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30909-6484
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-863-0200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 SHADY OAK CT
-----------------------------------------------------
City | WAYNESBORO
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30830-6485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-549-5766
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN-NP323686
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------