Healthcare Provider Details

I. General information

NPI: 1487540092
Provider Name (Legal Business Name): JESSECA FARR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9019 OVERLOOK BLVD STE C4
BRENTWOOD TN
37027-2749
US

IV. Provider business mailing address

1382 RURAL HILL RD UNIT 324
ANTIOCH TN
37013-2588
US

V. Phone/Fax

Practice location:
  • Phone: 615-274-9767
  • Fax: 833-450-4801
Mailing address:
  • Phone: 615-425-9790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39024
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: