Individual
MR. JESSE MCKINNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
80 HUXFORD ST, HOMERVILLE, GA 31634-2356
(229) 561-5592
Mailing address
PO BOX 298, HOMERVILLE, GA 31634-0298
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN204966
GA
Other
Enumeration date
03/30/2016
Last updated
01/23/2019
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