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General NPI Number Information
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NPI Number | 1972035152
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Entity Type | Organization
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Legal Business Name | BAXLEY PRIMARY CARE, PC
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 950 S MAIN ST SUITE 1
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City | BAXLEY
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State | GA
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Zip | 31513-0162
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Country | US
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Telephone | 912-705-6866
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Fax | 912-705-6681
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Provider Business Mailing Address
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Address Line | 950 S MAIN ST SUITE 1
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City | BAXLEY
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State | GA
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Zip | 31513-0162
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Country | US
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Telephone | 912-705-6866
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Fax | 912-705-6681
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. JANEY B BRITT
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Credential | FNP-C
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Telephone | 912-705-6866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN115507
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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 | RN115507
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License Number State | GA
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