MEDICARE: JENNIFER LYNN BARTLETT MSN, APRN, CPNP-PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	RN174815	GA

General Provider Information

NPI Number	:	1124832282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN BARTLETT MSN, APRN, CPNP-PC

Provider Business Mailing Address
First Line	:	5314 PARKSIDE TRL
Second Line	:
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-5189
Country	:	US
Telephone Number	:	678-939-9704
Fax Number	:	770-530-3342

Provider Business Practice Location Address
First Line	:	5226 DAHLONEGA HWY STE 3
Second Line	:
City	:	CLERMONT
State	:	GA
Zip	:	30527-1946
Country	:	US
Telephone Number	:	770-530-3342
Fax Number	:	770-530-3342

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2025
Last Update Date	:	02/06/2025

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