Healthcare Provider Details

I. General information

NPI: 1255310561
Provider Name (Legal Business Name): JENNIFER S BETTS MSN, FNP, PMH-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 HARDING PIKE STE B-227
NASHVILLE TN
37205-2119
US

IV. Provider business mailing address

4525 HARDING PIKE STE B-227
NASHVILLE TN
37205-2119
US

V. Phone/Fax

Practice location:
  • Phone: 615-730-5832
  • Fax: 615-581-2324
Mailing address:
  • Phone: 615-730-5832
  • Fax: 615-581-2324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN7088
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN0000103251
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: