Provider Demographics
NPI:1861659260
Name:DYE, JESSICA (NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:VIOLET
Other - Last Name:PENNINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 CHILDRENS WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0005
Mailing Address - Country:US
Mailing Address - Phone:615-936-1840
Mailing Address - Fax:
Practice Address - Street 1:2200 CHILDRENS WAY
Practice Address - Street 2:SUITE 3103
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-936-1840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily