Individual
WANDA JARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
115 JUDGE GRESHAM RD STE B, GRAY, TN 37615-6213
(423) 477-2010
Mailing address
115 JUDGE GRESHAM RD STE B, GRAY, TN 37615-6213
(423) 477-2010
(423) 477-2161
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21429
TN
363LW0102X
Women's Health Nurse Practitioner
21429
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21429
LICENSE
TN
01
—
3714470
GROUP MEDICARE
TN
Enumeration date
12/20/2016
Last updated
05/31/2024
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