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Individual

MRS. JILL K DENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
131 S WEBB AVE, CROSSVILLE, TN 38555-8452
(931) 484-5379
(931) 484-5946
Mailing address
131 S WEBB AVE, CROSSVILLE, TN 38555-8452
(931) 484-5379
(931) 484-5946

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000260
TN
363AM0700X
Medical Physician Assistant
Primary
PA260
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00260
STATE LICENSE
TN
01
12407183
CAQH
TN
05
1530022
TN
01
200006546
RAILROAD MEDICARE
TN
01
4084528
BCBS
TN
01
4342947
BCBS TENNESSEE
TN
05
Q000217
TN
Enumeration date
01/12/2007
Last updated
07/06/2016
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