Individual
TAMMY S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 20TH AVE N, STE 301, NASHVILLE, TN 37203-2131
(615) 329-0570
Mailing address
300 20TH AVE N, STE 301, NASHVILLE, TN 37203-2131
(615) 329-0570
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
113718
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3901205
—
TN
Enumeration date
07/21/2006
Last updated
07/08/2007
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