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Individual

SHANNON JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1901 CLINCH AVE, KNOXVILLE, TN 37916-2307
(865) 541-1111
Mailing address
500 MOUNTAIN PASS LN, KNOXVILLE, TN 37923-5723
(615) 351-7608

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
124643
TN

Other

Enumeration date
01/03/2019
Last updated
04/12/2021
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