Provider Demographics
NPI:1346752250
Name:PAGOAGA, JENNIFER CRONE (APN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CRONE
Last Name:PAGOAGA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 WHITE BRIDGE RD STE 103-243
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1444
Mailing Address - Country:US
Mailing Address - Phone:615-673-6737
Mailing Address - Fax:800-474-4039
Practice Address - Street 1:2323 21ST AVE S FL 3
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4930
Practice Address - Country:US
Practice Address - Phone:615-673-6737
Practice Address - Fax:800-474-4039
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily