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NPI Code Detail

MEDICARE: MRS. JENNIFER WISE NP-C

MEDICARE: MRS. JENNIFER WISE NP-C
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
1363LF0000XFamily Nurse Practitioner19675TN

General Provider Information

NPI Number : 1467836742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER WISE NP-C
Provider Business Mailing Address
First Line : 300 20TH AVE N STE 403
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-5180
Country : US
Telephone Number : 615-284-4029
Fax Number : 615-284-7501
Provider Business Practice Location Address
First Line : 114 SAUNDERSVILLE RD
Second Line :
City : HENDERSONVILLE
State : TN
Zip : 37075-8967
Country : US
Telephone Number : 629-888-5175
Fax Number : 629-888-5176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2015
Last Update Date : 08/12/2019

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