Provider Demographics
NPI:1427039221
Name:BOMBARDI-MOUNT, JENNIFER EDYTHE (CFNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:EDYTHE
Last Name:BOMBARDI-MOUNT
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2838
Mailing Address - Country:US
Mailing Address - Phone:615-890-8605
Mailing Address - Fax:
Practice Address - Street 1:515 STONECREST PKWY
Practice Address - Street 2:AMERICA'S FAMILY DOCTORS
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6826
Practice Address - Country:US
Practice Address - Phone:615-818-9888
Practice Address - Fax:615-523-2900
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0443439Medicaid
TN4108220OtherBCBS TN
TN4108220OtherBCBS TN
TN440137Medicare Oscar/Certification
MB0536283OtherDEA
TN0443439Medicaid
TN443439Medicare Oscar/Certification
TN103I500439Medicare PIN