Healthcare Provider Details

I. General information

NPI: 1083971303
Provider Name (Legal Business Name): JESSICA ALLISON MCAFEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 TAKOMA AVE
GREENEVILLE TN
37743-4629
US

IV. Provider business mailing address

509 MED TECH PKWY STE 100
JOHNSON CITY TN
37604-2579
US

V. Phone/Fax

Practice location:
  • Phone: 423-636-0491
  • Fax: 423-636-2425
Mailing address:
  • Phone: 423-302-6565
  • Fax: 423-952-2175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number180043
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number24569
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: