Individual
JACLYN BANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
655 LEXINGTON AVE, JACKSON, TN 38301-5075
(731) 540-0330
Mailing address
655 LEXINGTON AVE, JACKSON, TN 38301-5075
(731) 540-0330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19616
TN
Other
Enumeration date
02/03/2015
Last updated
01/26/2025
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