Provider Demographics
NPI:1811982242
Name:MULLEN, JENNY E (FNP)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:E
Last Name:MULLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:300 20TH AVE N STE G1
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2132
Practice Address - Country:US
Practice Address - Phone:615-941-8550
Practice Address - Fax:615-941-8507
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7000363LF0000X
TN100380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100028080Medicaid
TN3344909Medicaid
TNP00020470OtherRAILROAD MEDICARE
KY7100028080Medicaid
TNP88783Medicare UPIN