Provider Demographics
NPI:1245529486
Name:WRIGHT, JENNIFER JO (MSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JO
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JO
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:310 25TH AVE N
Mailing Address - Street 2:STE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1515
Mailing Address - Country:US
Mailing Address - Phone:615-329-0195
Mailing Address - Fax:615-329-0211
Practice Address - Street 1:5073 COLUMBIA PIKE
Practice Address - Street 2:STE 150
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-8607
Practice Address - Country:US
Practice Address - Phone:615-302-2990
Practice Address - Fax:615-302-4638
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015477363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006602Medicaid