Healthcare Provider Details

I. General information

NPI: 1174432645
Provider Name (Legal Business Name): JAMIE LEE BAXTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1064 N GATEWAY AVE STE 5
ROCKWOOD TN
37854-4023
US

IV. Provider business mailing address

1064 N GATEWAY AVE STE 5
ROCKWOOD TN
37854-4023
US

V. Phone/Fax

Practice location:
  • Phone: 865-368-6938
  • Fax:
Mailing address:
  • Phone: 865-368-6938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number172097
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: