Provider Demographics
NPI:1962686592
Name:WILLIAMS, JENNIFER (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1347
Mailing Address - Country:US
Mailing Address - Phone:615-792-1911
Mailing Address - Fax:
Practice Address - Street 1:200 N ANDERSON LN
Practice Address - Street 2:SUITE 106
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6934
Practice Address - Country:US
Practice Address - Phone:615-499-4545
Practice Address - Fax:615-499-4546
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6064157OtherBCBS
TN1521894Medicaid
TN6064157OtherBCBS
TN1521894Medicaid
TN3341944Medicare PIN