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General NPI Number Information
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NPI Number | 1861487118
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Entity Type | Individual
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Provider Name | JESSICA JERNIGAN P.A.
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Gender | Female
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 5544 OLD HICKORY BLVD
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City | HERMITAGE
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State | TN
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Zip | 37076-2576
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Country | US
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Telephone | 615-515-0029
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Fax | 615-515-0030
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone | 615-515-0029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 847
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA847
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License Number State | TN
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