Healthcare Provider Details

I. General information

NPI: 1790113595
Provider Name (Legal Business Name): KAMEELA E WILLIAMS-JACKSON APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5653 FRIST BLVD SUITE 630
HERMITAGE TN
37076-2062
US

IV. Provider business mailing address

222 22ND AVE N SUITE 100
NASHVILLE TN
37203-1852
US

V. Phone/Fax

Practice location:
  • Phone: 615-391-3971
  • Fax: 615-232-3899
Mailing address:
  • Phone: 615-284-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18127
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18127
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: