Jasmine Bynes, MA1,PH1, NTI
Individual provider Active NPI Specialist · Swainsboro, GA
NPI 1790449031 · NPPES record last updated Oct 26, 2021
Key facts
- NPI
- 1790449031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- COI-002022 (GA)
- Practice address
- 214 W Main St Ste 214a
Swainsboro, GA 30401-3150 - Phone
- (912) 245-9332
- NPI assigned
- Oct 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COI-002022 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ace Hair Rejuvenation and Wellness Clinic | Current |
Accepting new patients |
Locations
214 W Main St
Ste 214A
Swainsboro, GA 30401
Phone (912) 245-9332
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | COI-002022 | GA | Yes |
Addresses
Primary practice location
214 W Main St Ste 214a
Swainsboro, GA 30401-3150
Mailing address
1702 North St E
Vidalia, GA 30474-8721
Phone (912) 380-2228
Other providers in Swainsboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.