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General NPI Number Information
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NPI Number | 1811460975
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Entity Type | Individual
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Provider Name | JOAN I AURA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 502 E GENERAL STEWART WAY STE A
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City | HINESVILLE
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State | GA
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Zip | 31313-2643
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Country | US
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Telephone | 912-368-1959
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Fax | 912-368-1966
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Provider Business Mailing Address
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Address Line | 2129 NASHVILLE ST
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City | JOPLIN
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State | MO
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Zip | 64801-1347
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Country | US
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Telephone | 417-622-6450
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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 | 2019000937
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP000111
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License Number State | GA
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