Provider Demographics
NPI:1922074723
Name:JAYARAM, JENNIFER ERIN NALLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ERIN NALLE
Last Name:JAYARAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:719 THOMPSON LN
Practice Address - Street 2:SUITE 22200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3609
Practice Address - Country:US
Practice Address - Phone:615-322-8134
Practice Address - Fax:615-343-7705
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF334485363LF0000X
TN139899163W00000X
TN12722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02591160Medicaid
NY0862G1Medicare ID - Type Unspecified
NY02591160Medicaid