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Individual

KRISTIE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
4230 HARDING PIKE, SUITE 330, NASHVILLE, TN 37205
(615) 269-4545
(615) 565-6789
Mailing address
300 20TH AVE N STE 403, NASHVILLE, TN 37203-5180
(615) 284-7260
(615) 284-7501

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN0000010926
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
10926
TN
363LA2100X
Acute Care Nurse Practitioner
2004003624
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1519858
TN
01
6011957
BCBS
TN
01
P01167551
RR MEDICARE
TN
Enumeration date
01/23/2006
Last updated
07/10/2018
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