MEDICARE: MRS. JESSICA ORTEGA FNP-BC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	41109	TN

General Provider Information

NPI Number	:	1134072820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA ORTEGA FNP-BC

Provider Business Mailing Address
First Line	:	6020 CAINSVILLE RD
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37090-7735
Country	:	US
Telephone Number	:	615-987-0332
Fax Number	:	615-984-4960

Provider Business Practice Location Address
First Line	:	819 MEDICAL PARK
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167
Country	:	US
Telephone Number	:	615-987-0332
Fax Number	:

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

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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