Individual
JOHN JACOB WHICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1005 UNION SCHOOL RD, GALLATIN, TN 37066-2084
(615) 206-1120
(615) 206-9448
Mailing address
1005 UNION SCHOOL RD, GALLATIN, TN 37066-2084
(615) 206-1120
(615) 206-9448
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000202225
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155541
BLUE CROSS BLUE SHIELD TENNESSEE
TN
01
—
3910472
MEDICARE
TN
05
—
4447971
—
TN
01
—
600000198
RAILROAD
TN
01
—
62-6001445TN0101
AMERICHOICE
TN
Enumeration date
08/10/2015
Last updated
08/10/2015
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