Provider Demographics
NPI:1588021356
Name:LEVY, JERRIN O (PA-C)
Entity type:Individual
Prefix:MISS
First Name:JERRIN
Middle Name:O
Last Name:LEVY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JERRIN
Other - Middle Name:O
Other - Last Name:NABERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:599 OAK RIDGE TPKE
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7177
Mailing Address - Country:US
Mailing Address - Phone:865-482-2129
Mailing Address - Fax:865-482-4036
Practice Address - Street 1:599 OAK RIDGE TPKE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7177
Practice Address - Country:US
Practice Address - Phone:865-482-2129
Practice Address - Fax:865-482-4036
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000002945363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical