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NPI Code Detail

MEDICARE: JEANNA MARIE DAMICO

MEDICARE: JEANNA MARIE DAMICO
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1902604036
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNA MARIE DAMICO
Provider Business Mailing Address
First Line : 200 TECH CENTER DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-2747
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MERCHANTS CENTER BLVD STE 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-3473
Country : US
Telephone Number : 865-257-9982
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2025
Last Update Date : 03/05/2025

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Directions to “ JEANNA MARIE DAMICO ” Practice Location

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