Organization
MINOR REQUEST
Active
Organization
MINOR REQUEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENISE MINOR (OWNER)
(731) 803-8850
Entity
Organization
Contact information
Practice address
10 NETHERWOOD DR, JACKSON, TN 38305-9441
(731) 803-8850
Mailing address
10 NETHERWOOD DR, JACKSON, TN 38305-9441
(731) 803-8850
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
347C00000X
TN
Other
Enumeration date
05/25/2010
Last updated
05/25/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up