Provider Demographics
NPI:1902507353
Name:CYPHERS, JENNY LYNN (NP)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:LYNN
Last Name:CYPHERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:LYNN
Other - Last Name:MARRS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-302-6565
Mailing Address - Fax:
Practice Address - Street 1:590 W RIDGE RD STE D
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1067
Practice Address - Country:US
Practice Address - Phone:276-228-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184548363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care