Provider Demographics
NPI:1588045132
Name:OLIVE, JASMINE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
Last Name:OLIVE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:127 N OAK AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2435
Mailing Address - Country:US
Mailing Address - Phone:931-783-5857
Mailing Address - Fax:931-526-6760
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-783-2497
Practice Address - Fax:931-783-5666
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2023-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-128366363LA2200X
GARN255482363LA2200X
TN21106363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6067989OtherBCBS
TNQ022320Medicaid
KY7100413450Medicaid