Provider Demographics
NPI:1346000502
Name:TWILLEY, JORDANNA BROOKE (RN)
Entity Type:Individual
Prefix:
First Name:JORDANNA
Middle Name:BROOKE
Last Name:TWILLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 SAINT FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6367
Mailing Address - Country:US
Mailing Address - Phone:615-971-0056
Mailing Address - Fax:
Practice Address - Street 1:508 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6367
Practice Address - Country:US
Practice Address - Phone:615-971-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000213720163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse