Provider Demographics
NPI:1336104645
Name:WEBER, JENNIFER R (GNP, MSN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:WEBER
Suffix:
Gender:F
Credentials:GNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 CHURCH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2021
Mailing Address - Country:US
Mailing Address - Phone:615-342-0038
Mailing Address - Fax:615-329-4469
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-342-0038
Practice Address - Fax:615-329-4469
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN123260163W00000X
TN7895363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4079335OtherBLUE CROSS/BLUE SHIELD
MW0575893OtherDEA
Q13976Medicare UPIN
4079335OtherBLUE CROSS/BLUE SHIELD