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General NPI Number Information
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NPI Number | 1811643422
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Entity Type | Individual
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Provider Name | JENNIFER CHARLENE PEAN-WINSTON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 252 SHANNON WAY STE B
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3793
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Country | US
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Telephone | 678-272-5111
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Fax | 404-678-4616
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Provider Business Mailing Address
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Address Line | 3685 WARWICK WAY
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City | SNELLVILLE
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State | GA
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Zip | 30039-8069
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Country | US
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Telephone | 404-409-9439
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 253360
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License Number State | GA
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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 | F02220878
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License Number State | GA
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