Provider Demographics
NPI:1528335288
Name:SKINNER, JADE M (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:JADE
Middle Name:M
Last Name:SKINNER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1020 DR. MLK JR BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-622-4644
Mailing Address - Fax:615-770-2704
Practice Address - Street 1:2025 N MOUNT JULIET RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3316
Practice Address - Country:US
Practice Address - Phone:615-773-2712
Practice Address - Fax:615-773-2707
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2020-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN16218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner