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NPI Code Detail

MEDICARE: JANNA NOVOTNY LISTER NP-C

MEDICARE: JANNA NOVOTNY LISTER NP-C
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
1363L00000XNurse PractitionerAPRN-NP173974GA

General Provider Information

NPI Number : 1528478344
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNA NOVOTNY LISTER NP-C
Provider Business Mailing Address
First Line : PO BOX 12938
Second Line : C/O CLINIC MANAGEMENT
City : CALHOUN
State : GA
Zip : 30703
Country : US
Telephone Number : 706-602-7800
Fax Number :
Provider Business Practice Location Address
First Line : 21 COMMERCE PKWY
Second Line :
City : ADAIRSVILLE
State : GA
Zip : 30103-2009
Country : US
Telephone Number : 770-773-9201
Fax Number : 770-773-9219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2014
Last Update Date : 10/27/2025

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