Provider Demographics
NPI:1568985547
Name:SHEDD, JESSICA DION (NP-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DION
Last Name:SHEDD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1389
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-1389
Mailing Address - Country:US
Mailing Address - Phone:423-949-6300
Mailing Address - Fax:423-949-6374
Practice Address - Street 1:15166 RANKIN AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-7039
Practice Address - Country:US
Practice Address - Phone:423-949-6300
Practice Address - Fax:423-949-6374
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22803363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner