Individual
DR. NICOLE MICHELLE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
116 W MAIN ST, HENDERSON, TN 38340-2231
(731) 989-0001
(731) 989-5151
Mailing address
116 W MAIN ST, HENDERSON, TN 38340-2231
(731) 989-0001
(731) 989-5151
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD0000034823
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3867610
—
TN
01
—
P00111567
RAILROAD MEDICARE
TN
Enumeration date
09/15/2005
Last updated
01/26/2021
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