Provider Demographics
NPI:1386871895
Name:GARRARD, JEREMY E (APRN)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:E
Last Name:GARRARD
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 LANGFORD DR BLDG 400-103
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7370
Mailing Address - Country:US
Mailing Address - Phone:706-521-8413
Mailing Address - Fax:706-521-8354
Practice Address - Street 1:1747 LANGFORD DR BLDG 400-103
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7370
Practice Address - Country:US
Practice Address - Phone:706-521-8413
Practice Address - Fax:706-521-8354
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN188785363LA2200X, 363LA2200X
NM61461363LA2200X
TX791802163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
1386871895OtherNPI