Individual
JENNIFER CARLISLE MCKEOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
109 HIGHWAY 70 N, ROGERSVILLE, TN 37857-4001
(423) 272-3099
(423) 272-6591
Mailing address
12201 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2361
(502) 568-7366
(502) 568-7114
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
15721
TN
363LA2200X
Adult Health Nurse Practitioner
15721
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525126
—
TN
Enumeration date
03/25/2011
Last updated
05/18/2015
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