Healthcare Provider Details

I. General information

NPI: 1881518017
Provider Name (Legal Business Name): JESSICA LOUISE EVERETT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA LOUISE HASKIN

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 GALECKI DR
SIGNAL MOUNTAIN TN
37377-7439
US

IV. Provider business mailing address

222 GALECKI DR
SIGNAL MOUNTAIN TN
37377-7439
US

V. Phone/Fax

Practice location:
  • Phone: 423-667-7338
  • Fax:
Mailing address:
  • Phone: 423-667-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number238584
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: