Individual
JANA HART BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1000 NEWTON RD, CAMILLA, GA 31730-5411
(229) 889-7393
Mailing address
1000 NEWTON RD, CAMILLA, GA 31730-5411
(229) 889-7393
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
252123
GA
Other
Enumeration date
09/12/2018
Last updated
11/04/2024
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