MS. JUDY ANN BACON (NPI# 1639517311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639517311 |
| Entity Type | Individual |
| Full Name | MS. JUDY ANN BACON |
| Credential | LPN |
| Practice Address |
11 Robin Hood Rd Statesboro GA 30458-1675 |
| Practice Telephone | 9126781131 |
| Practice Fax Number | 9128713987 |
| Mailing Telephone | 9126781131 |
| Mailing Fax Number | 9128713987 |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | LPN032393 | GA | Nursing Service Providers |
| Street Address |
11 ROBIN HOOD RD |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-1675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639338684 | Inga Demetria Paulk- Johnson | Licensed Practical Nurse | 115 Lee St, Statesboro, GA 30458-2102 | 2008-06-05 |
| 1255590402 | Justin Ray | Licensed Practical Nurse | 2014 Pinemount Blvd, Statesboro, GA 30461-2358 | 2008-06-03 |
| 1831358894 | Barbara Nell Rooks | Licensed Practical Nurse | 4 W Altman St, Statesboro, GA 30458-5277 | 2008-06-05 |
| 1417116815 | Angela Laura Quinn | Licensed Practical Nurse | 4 W Altman St, Statesboro, GA 30458-5277 | 2008-06-02 |
| 1164680740 | Juliet S Givens | Licensed Practical Nurse | 4 W Altman St, Statesboro, GA 30458-5277 | 2008-05-30 |
| 1457519423 | Carolyn Denise Odom | Licensed Practical Nurse | 4 W Altman St, Statesboro, GA 30458-5277 | 2008-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961557 | Christina Jarvis-reid | Licensed Practical Nurse | 211 Lasso Dr, Riverdale, GA 30274-4095 | 2020-10-28 |
| 1326646639 | Yolanda Glover-harden | Licensed Practical Nurse | 6214 Hickory Lane Cir, Union City, GA 30291-5509 | 2020-10-09 |
| 1831706423 | Sonia Dareus | Licensed Practical Nurse | 1495 Cain Ct N, Douglasville, GA 30134-3681 | 2020-09-28 |
| 1609482140 | Antronette Darrell | Licensed Practical Nurse | 1578 Cherry Hill Rd Sw, Conyers, GA 30094-6835 | 2020-09-21 |
| 1760097778 | Christal Latrice Callier | Licensed Practical Nurse | 1995 Matt Dr, Austell, GA 30168-4330 | 2020-09-15 |
| 1356955678 | Marica Lashone Sanders | Licensed Practical Nurse | 301 -3 Club Villa Court, Kathleen, GA 31047 | 2020-09-03 |
| 1689287641 | Lydia Gennie | Licensed Practical Nurse | 1004 Shoreline Dr, Bainbridge, GA 39817-8393 | 2020-08-28 |
| 1558972588 | Starla Lynn Waddell | Licensed Practical Nurse | 675a Moran Lake Rd Ne, Rome, GA 30161-2106 | 2020-08-13 |
| 1700495975 | Shalunda Harrison | Licensed Practical Nurse | 4311 Christine Ct, Decatur, GA 30035-1702 | 2020-07-23 |
| 1902414683 | Vernita Monica Washington | Licensed Practical Nurse | 1974 Talmadge Rd, Allenhurst, GA 31301-3201 | 2020-07-17 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.