Individual
DANA BUCK IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2610 HIGHWAY 129 N, JEFFERSON, GA 30549-2652
(706) 367-1010
(706) 367-1050
Mailing address
2610 HIGHWAY 129 N, JEFFERSON, GA 30549-2652
(706) 367-1010
(706) 367-1050
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN129153
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000875938B
—
GA
05
—
1336411347
—
GA
Enumeration date
09/15/2008
Last updated
03/05/2012
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