Healthcare Provider Details

I. General information

NPI: 1821911215
Provider Name (Legal Business Name): JODI ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 WILEY PARKER RD STE H
JACKSON TN
38305-5806
US

IV. Provider business mailing address

3515 PLEASANT SPRINGS RD
HENDERSON TN
38340-7468
US

V. Phone/Fax

Practice location:
  • Phone: 731-660-0900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number88211
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number15465
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: