Provider Demographics
NPI:1144228339
Name:ACUFF, JESSICA JOLENE (FNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JOLENE
Last Name:ACUFF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 SULPHUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5654
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:7719 HIGHWAY 131
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:TN
Practice Address - Zip Code:37888-4055
Practice Address - Country:US
Practice Address - Phone:865-497-2591
Practice Address - Fax:865-497-3803
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN105614363LF0000X
TNAPN7197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3904682Medicaid
TN3904682Medicaid
TN3904682Medicare ID - Type Unspecified