Provider Demographics
NPI:1295442929
Name:KEYES, JESSICA (FNP-BC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KEYES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:STOECKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5651 FRIST BLVD STE 603
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2079
Mailing Address - Country:US
Mailing Address - Phone:615-889-1968
Mailing Address - Fax:615-889-8527
Practice Address - Street 1:5651 FRIST BLVD STE 603
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2079
Practice Address - Country:US
Practice Address - Phone:615-889-1968
Practice Address - Fax:615-889-8527
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023132363L00000X
TN32973363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty