Provider Demographics
NPI:1396452702
Name:MERRIEL, JESSICA RAE ROBINSON (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE ROBINSON
Last Name:MERRIEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RAE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 JOHNNY CASH BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2602
Mailing Address - Country:US
Mailing Address - Phone:856-472-3615
Mailing Address - Fax:
Practice Address - Street 1:625 JOHNNY CASH BLVD STE 3
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2602
Practice Address - Country:US
Practice Address - Phone:856-472-3615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA9147363A00000X
TN6561363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant