Healthcare Provider Details

I. General information

NPI: 1871925818
Provider Name (Legal Business Name): JENNY KAY CAREGIVERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3132 POSSUM TROT RD
GREENBRIER TN
37073-4718
US

IV. Provider business mailing address

3132 POSSUM TROT RD
GREENBRIER TN
37073-4718
US

V. Phone/Fax

Practice location:
  • Phone: 615-389-8160
  • Fax: 615-863-0045
Mailing address:
  • Phone: 615-389-8160
  • Fax: 615-863-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1000000012892
License Number StateTN

VIII. Authorized Official

Name: KIMBERLY K HALL
Title or Position: OWNER
Credential:
Phone: 615-389-8160