Individual
JAQUETTA J WOLF-KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
490 DUNLOP LN, CLARKSVILLE, TN 37040-5007
(931) 245-8600
(931) 245-8660
Mailing address
PO BOX 3799, CLARKSVILLE, TN 37043-3799
(931) 245-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18974
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q011918
—
TN
Enumeration date
10/13/2014
Last updated
08/30/2022
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