Healthcare Provider Details

I. General information

NPI: 1295552537
Provider Name (Legal Business Name): HANNAH CAROLINE JENNINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 DOOLITTLE RD
WOODBURY TN
37190-1139
US

IV. Provider business mailing address

324 DOOLITTLE RD
WOODBURY TN
37190-1139
US

V. Phone/Fax

Practice location:
  • Phone: 615-563-4001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number37034
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: