Individual
MRS. JESSICA ELAINE LIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 498-5656
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
014113
TN
Other
Enumeration date
04/27/2009
Last updated
04/14/2025
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