Individual
TRAVIS B JENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAAA
Contact information
Practice address
1968 PEACHTREE ROAD NW, ATLANTA, GA 30309-1281
(404) 351-1745
(404) 351-7121
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
005385
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124886377A
—
GA
Enumeration date
09/22/2008
Last updated
09/29/2011
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