Provider Demographics
NPI:1417425257
Name:MINK, JENNY LEE (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LEE
Last Name:MINK
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:615-329-0579
Practice Address - Street 1:2004 HAYES ST STE 350
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2650
Practice Address - Country:US
Practice Address - Phone:615-312-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-096591163W00000X, 363LF0000X
TN29511363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily