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General NPI Number Information
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NPI Number | 1942169966
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Entity Type | Organization
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Legal Business Name | TWISTED ROOTS HEALTHCARE
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 105 KLM DR STE 14
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City | JOHNSON CITY
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State | TN
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Zip | 37615-3693
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Country | US
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Telephone | 423-367-7688
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Fax |
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Provider Business Mailing Address
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Address Line | 823 LIBERTY CHURCH RD
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City | KINGSPORT
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State | TN
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Zip | 37663-4614
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Country | US
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Telephone | 423-367-7688
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EVA M JESSEE
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Credential | FNP-BC
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Telephone | 423-367-7688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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