Healthcare Provider Details

I. General information

NPI: 1386136539
Provider Name (Legal Business Name): JAIME ELAINE PESL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 BATTLEFIELD PKWY
RINGGOLD GA
30736-8011
US

IV. Provider business mailing address

2004 HAYES ST STE 800
NASHVILLE TN
37203-2659
US

V. Phone/Fax

Practice location:
  • Phone: 423-648-2362
  • Fax: 423-648-9294
Mailing address:
  • Phone: 615-329-0570
  • Fax: 615-329-0579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP222619
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP222619
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: