Provider Demographics
NPI:1982913729
Name:GARNER, JESSICA APRIL (CRNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:APRIL
Last Name:GARNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:APRIL
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:300 3RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-3665
Mailing Address - Country:US
Mailing Address - Phone:601-849-5070
Mailing Address - Fax:601-849-0626
Practice Address - Street 1:300 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3665
Practice Address - Country:US
Practice Address - Phone:601-849-5070
Practice Address - Fax:601-849-0626
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily