Provider Demographics
NPI:1609249077
Name:STARKEY, JENNIFER MILLER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MILLER
Last Name:STARKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 LEWIS JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-4837
Mailing Address - Country:US
Mailing Address - Phone:615-260-2951
Mailing Address - Fax:
Practice Address - Street 1:1559 NEW HIGHWAY 52 E
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:TN
Practice Address - Zip Code:37186-2243
Practice Address - Country:US
Practice Address - Phone:615-644-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-07
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2844225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant