Provider Demographics
NPI:1982689329
Name:ANDERS, JENNIFER LASH (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LASH
Last Name:ANDERS
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 1:3428 HACKWORTH RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-2309
Mailing Address - Country:US
Mailing Address - Phone:865-539-5348
Mailing Address - Fax:
Practice Address - Street 1:140 DAMERON AVE
Practice Address - Street 2:KCHD
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917
Practice Address - Country:US
Practice Address - Phone:865-215-5320
Practice Address - Fax:865-215-5340
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008242363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health