Provider Demographics
NPI:1225170160
Name:STEELE, JENNIFER LOUISE (APRN, BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOUISE
Last Name:STEELE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SUGARFOOT WAY
Mailing Address - Street 2:
Mailing Address - City:PIGEON FORGE
Mailing Address - State:TN
Mailing Address - Zip Code:37863-6204
Mailing Address - Country:US
Mailing Address - Phone:865-453-9045
Mailing Address - Fax:865-374-2160
Practice Address - Street 1:119 SUGARFOOT WAY
Practice Address - Street 2:
Practice Address - City:PIGEON FORGE
Practice Address - State:TN
Practice Address - Zip Code:37863-6204
Practice Address - Country:US
Practice Address - Phone:865-453-9045
Practice Address - Fax:865-374-2160
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514167Medicaid