Individual
MS. LISA ANN JAYCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3001 LAKE BROOK BLVD STE 101, KNOXVILLE, TN 37909-3761
(865) 374-0600
Mailing address
3001 LAKE BROOK BLVD STE 101, KNOXVILLE, TN 37909-3761
(865) 374-0600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9208812
FL
363L00000X
Nurse Practitioner
ARNP9208812
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
31303
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020717700
—
FL
01
—
IY900Z
MEDICARE
FL
01
—
TGWF7
BCBS
FL
Enumeration date
03/05/2012
Last updated
10/20/2022
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