MEDICARE: MS. JADE M SKINNER FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APN16218	TN

General Provider Information

NPI Number	:	1528335288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JADE M SKINNER FNP-BC

Provider Business Mailing Address
First Line	:	1020 DR. MLK JR BLVD
Second Line	:	SUITE 120
City	:	NASHVILLE
State	:	TN
Zip	:	37203
Country	:	US
Telephone Number	:	615-622-4644
Fax Number	:	615-770-2704

Provider Business Practice Location Address
First Line	:	2025 N MOUNT JULIET RD
Second Line	:	SUITE 120
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-3316
Country	:	US
Telephone Number	:	615-773-2712
Fax Number	:	615-773-2707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2011
Last Update Date	:	01/24/2020

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