MEDICARE: MRS. JENNIFER ERIN NALLE JAYARAM NP

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	F334485	NY
2	163W00000X	Registered Nurse	139899	TN
3	363LF0000X	Family Nurse Practitioner	12722	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922074723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ERIN NALLE JAYARAM NP

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	719 THOMPSON LN
Second Line	:	SUITE 22200
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3609
Country	:	US
Telephone Number	:	615-322-8134
Fax Number	:	615-343-7705

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	03/18/2022

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