Provider Demographics
NPI:1770632283
Name:FARMER, JENNIFER JUANITA (APN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JUANITA
Last Name:FARMER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 PARK WEST BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4308
Mailing Address - Country:US
Mailing Address - Phone:865-690-3003
Mailing Address - Fax:865-690-6404
Practice Address - Street 1:9330 PARK WEST BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4308
Practice Address - Country:US
Practice Address - Phone:865-690-3003
Practice Address - Fax:865-690-6404
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007419363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN0000007419OtherADVANCED PRACTICE NURSE
TNQ010257Medicaid