Individual
JENNIFER B MCMAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0012
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN286609
GA
163WN0002X
Neonatal Intensive Care Registered Nurse
RN286609
GA
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
RN286609
GA
Other
Enumeration date
02/13/2020
Last updated
05/17/2024
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