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NPI Code Detail

MEDICARE: DR. JENNIFER BLEDAY BURT DNP, FNP-BC

MEDICARE: DR. JENNIFER BLEDAY BURT DNP, FNP-BC
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
1207R00000XInternal Medicine PhysicianRN2165872GA

General Provider Information

NPI Number : 1588317804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER BLEDAY BURT DNP, FNP-BC
Provider Business Mailing Address
First Line : 5345 NORTHSIDE DR
Second Line :
City : MACON
State : GA
Zip : 31210-1500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5345 NORTHSIDE DR
Second Line :
City : MACON
State : GA
Zip : 31210-1500
Country : US
Telephone Number : 814-671-5870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2022
Last Update Date : 03/02/2026

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