Provider Demographics
NPI:1144671769
Name:GILMER, JODI BRANNEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JODI
Middle Name:BRANNEN
Last Name:GILMER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:961 E WINTHROPE AVE
Mailing Address - Street 2:
Mailing Address - City:MILLEN
Mailing Address - State:GA
Mailing Address - Zip Code:30442-1839
Mailing Address - Country:US
Mailing Address - Phone:478-982-0120
Mailing Address - Fax:478-982-4605
Practice Address - Street 1:961 E WINTHROPE AVE
Practice Address - Street 2:
Practice Address - City:MILLEN
Practice Address - State:GA
Practice Address - Zip Code:30442-1839
Practice Address - Country:US
Practice Address - Phone:478-982-0120
Practice Address - Fax:478-982-4605
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA7975363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant