Healthcare Provider Details

I. General information

NPI: 1669279618
Provider Name (Legal Business Name): JENNIFER L. SADLOWSKI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 WOODLAND TRACE LN
CORDOVA TN
38018-6609
US

IV. Provider business mailing address

103 W ARROWWOOD RD
OAK RIDGE TN
37830-5706
US

V. Phone/Fax

Practice location:
  • Phone: 888-551-2538
  • Fax: 844-364-2629
Mailing address:
  • Phone: 703-228-9744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number38313
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: