Provider Demographics
NPI:1164613907
Name:BYRD, JESSICA LYNN (WHNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:BYRD
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SNAKE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37022-4672
Mailing Address - Country:US
Mailing Address - Phone:615-497-6874
Mailing Address - Fax:
Practice Address - Street 1:437 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2982
Practice Address - Country:US
Practice Address - Phone:615-497-6874
Practice Address - Fax:615-452-8705
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN153196163W00000X
TN17195363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse