Healthcare Provider Details

I. General information

NPI: 1548709371
Provider Name (Legal Business Name): MRS. JASMINE JNO BAPTISTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 FRENCH LANDING DR
NASHVILLE TN
37228-1511
US

IV. Provider business mailing address

220 MAXWELL PL
ANTIOCH TN
37013-5813
US

V. Phone/Fax

Practice location:
  • Phone: 615-259-9055
  • Fax: 615-259-9056
Mailing address:
  • Phone: 615-800-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1150
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: