MEDICARE: MRS. JESSICA NANCE PMHNP-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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	32848	TN

General Provider Information

NPI Number	:	1295443562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA NANCE PMHNP-BC

Provider Business Mailing Address
First Line	:	626 BUFFALO RD
Second Line	:
City	:	HOHENWALD
State	:	TN
Zip	:	38462-1905
Country	:	US
Telephone Number	:	615-956-4825
Fax Number	:

Provider Business Practice Location Address
First Line	:	5221 PORT ROYAL RD
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-3511
Country	:	US
Telephone Number	:	615-439-6180
Fax Number	:	615-261-8683

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

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	07/02/2025

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