# JP PRIME HEALTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346714714
- **Authorized official:** JENNIFER PENDERGRAST APN-BC (NP)
- **Authorized official phone:** (931) 647-0269

## Contact information

- **Practice address:** 111 USSERY RD, CLARKSVILLE, TN 37043-4530
- **Practice address phone:** (931) 647-0269
- **Practice address fax:** (931) 553-8129
- **Mailing address:** 906 GLENRAVEN DR, CLARKSVILLE, TN 37043-8296
- **Mailing address phone:** (931) 436-3668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2019
- **Last updated:** 03/07/2019