MEDICARE: JESSE HENRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174400000X	Specialist
2	222Q00000X	Developmental Therapist
3	3747P1801X	Personal Care Attendant
4	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1003772476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE HENRY

Provider Business Mailing Address
First Line	:	1910 COUNTY HOSPITAL RD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37218-2606
Country	:	US
Telephone Number	:	914-619-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 COUNTY HOSPITAL RD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37218-2606
Country	:	US
Telephone Number	:	914-619-0155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

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Directions to “ JESSE HENRY ” Practice Location

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