Individual
FRANCES A. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, CS
Contact information
Practice address
109 W WATAUGA AVE, JOHNSON CITY, TN 37604-5621
(423) 232-2600
(423) 232-2646
Mailing address
1167 SPRATLIN DRIVE, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3710
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN06486
TN
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
APN06486
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100036825
PHP
TN
05
—
3343432
—
TN
01
—
4004827
BLUECROSSBLUESHIELD
TN
01
—
TN01D7
JOHN DEERE
TN
Enumeration date
07/04/2006
Last updated
07/20/2017
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