Bootle, Jennifer Boyd

Bootle, Jennifer Boyd is an individual health care provider with primary practice located at 14089 Abercorn St , Savannah GA 31419-1966. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bootle, Jennifer Boyd can be contacted via phone (912) 350-2121.

Contact Information

Primary practice address
14089 Abercorn St Savannah GA 31419-1966
Phone: (912) 350-2121
Fax: (912) 350-2145
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN227783 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 18172 South Carolina

Profile Details

NPI number 1417296898
LBN Legal business name Bootle, Jennifer Boyd
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2013
Last updated Nov 3rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417296898 NPPES
Georgia MEDICAID 003138354B
Georgia MEDICAID 003138354A
Georgia Other P01241129
Georgia MEDICAID 003138354C
Georgia MEDICAID 003138354D

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