Individual
JAYDEN RAE GRACIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 21ST AVE S, NASHVILLE, TN 37232-0011
(615) 875-5568
Mailing address
140 W 7TH ST, COOKEVILLE, TN 38501-1726
(931) 783-2497
(931) 783-5666
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
73236
TN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/16/2026
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