Provider Demographics
NPI:1851498703
Name:JACKSON, NANCI ELIZABETH (RN,MSN,CPNP)
Entity Type:Individual
Prefix:MS
First Name:NANCI
Middle Name:ELIZABETH
Last Name:JACKSON
Suffix:
Gender:F
Credentials:RN,MSN,CPNP
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Mailing Address - Street 1:6350 W A J HWY
Mailing Address - Street 2:DEPARTMENT 100
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:140 DAMERON AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-6413
Practice Address - Country:US
Practice Address - Phone:865-934-6100
Practice Address - Fax:865-342-0100
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005941363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics