Provider Demographics
NPI:1588317804
Name:BURT, JENNIFER BLEDAY (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BLEDAY
Last Name:BURT
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:BLEDAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, FNP-BC
Mailing Address - Street 1:5345 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 PRESTON CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5769
Practice Address - Country:US
Practice Address - Phone:478-238-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA52466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine