Individual
MRS. JEANIE MARIE VAN AKKEREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
862 CALLEN LN NW STE 110, CLEVELAND, TN 37312-7020
(423) 331-5025
Mailing address
2464 MAIN ST, PLANTERSVILLE, MS 38862-5002
(662) 842-4877
(662) 842-4330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R864955
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03573574
—
MS
01
—
207688
BLUE CROSS BLUE SHIELD OF MISSISSIPPI
MS
Enumeration date
05/07/2013
Last updated
07/13/2023
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