Provider Demographics
NPI:1134007685
Name:JAECKLE, EVONNE NICOLE (DC)
Entity type:Individual
Prefix:DR
First Name:EVONNE
Middle Name:NICOLE
Last Name:JAECKLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SADDLE SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-5328
Mailing Address - Country:US
Mailing Address - Phone:615-513-2890
Mailing Address - Fax:855-615-2840
Practice Address - Street 1:100 SADDLE SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-5328
Practice Address - Country:US
Practice Address - Phone:615-830-4640
Practice Address - Fax:855-615-2840
Is Sole Proprietor?:No
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor