Provider Demographics
NPI:1235247339
Name:WATSON, JENNIFER LYNN (APRN-BC, ACUTE CARE)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:WATSON
Suffix:
Gender:F
Credentials:APRN-BC, ACUTE CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6426
Mailing Address - Country:US
Mailing Address - Phone:615-867-6115
Mailing Address - Fax:615-867-5580
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-867-6000
Practice Address - Fax:615-867-5580
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000135742163WG0000X
TNAPN0000008325363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00102962OtherMEDICARE RAILROAD #
TN4089867OtherBCBS
TN4089867OtherBCBS
TN3908630Medicare ID - Type Unspecified