Individual
JESSICA R. STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
CORNER OF LAMONT AND VETERANS WAY, BUILDING 200, MOUNTAIN HOME, TN 37684-4000
(423) 926-1171
(423) 979-3554
Mailing address
PO BOX 4000, BUILDING 8 DOGWOOD AVENUE, MOUNTAIN HOME, TN 37684-4000
(423) 926-1171
(423) 979-3554
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6435
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3095873
—
TN
Enumeration date
09/16/2005
Last updated
10/08/2015
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