Individual
MRS. JENNIFER BOYD BOOTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
14089 ABERCORN ST, SAVANNAH, GA 31419-1966
(912) 350-2121
(912) 350-2145
Mailing address
14089 ABERCORN ST, SAVANNAH, GA 31419-1966
(912) 350-2121
(912) 350-2145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
18172
SC
363LF0000X
Family Nurse Practitioner
Primary
RN227783
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003138354A
—
GA
05
—
003138354B
—
GA
05
—
003138354C
—
GA
05
—
003138354D
—
GA
01
—
P01241129
RAILROAD MEDICARE
GA
Enumeration date
02/05/2013
Last updated
11/03/2014
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