Provider Demographics
NPI:1467879932
Name:CANTWELL, JESSICA GOLDEN (FNP-BC, APRN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GOLDEN
Last Name:CANTWELL
Suffix:
Gender:F
Credentials:FNP-BC, APRN
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Other - First Name:
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Mailing Address - Street 1:312 PROSPERITY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4721
Mailing Address - Country:US
Mailing Address - Phone:865-691-3155
Mailing Address - Fax:865-694-8093
Practice Address - Street 1:312 PROSPERITY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4721
Practice Address - Country:US
Practice Address - Phone:865-691-3155
Practice Address - Fax:865-694-8093
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2020-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN18489363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily