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Individual

JADE POWELL VERGARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-C

Contact information

Practice address
166 E MAIN ST, HENDERSONVILLE, TN 37075-2520
(615) 822-3000
(615) 348-0109
Mailing address
347 WOODYCREST AVE, NASHVILLE, TN 37210-4639

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
18347
TN
363LG0600X
Gerontology Nurse Practitioner
Primary
18347
TN

Other

Enumeration date
02/12/2014
Last updated
04/15/2015
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