Provider Demographics
NPI:1013803014
Name:WATSON-DUNCAN, JENNA RAE (PMHNP)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:RAE
Last Name:WATSON-DUNCAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 SHENANDOAH LN
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-6337
Mailing Address - Country:US
Mailing Address - Phone:505-220-4092
Mailing Address - Fax:505-220-4092
Practice Address - Street 1:1340 N GRUNDY QUARLES HWY
Practice Address - Street 2:
Practice Address - City:GAINESBORO
Practice Address - State:TN
Practice Address - Zip Code:38562-6001
Practice Address - Country:US
Practice Address - Phone:505-220-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38717363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health