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Individual

JENNIFER D. STEWART-GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2700 MAIN ST, SNEEDVILLE, TN 37869-3041
(423) 439-4515
(423) 439-4060
Mailing address
365 STOUT DRIVE BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4515
(423) 439-4060

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN008471
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100047078
PHP
TN
05
3649084
TN
01
4091215
BLUECROSSBLUESHIELD
TN
01
TN01M2
JOHN DEERE
TN
Enumeration date
07/07/2006
Last updated
07/20/2016
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