Provider Demographics
NPI:1538523162
Name:GUNSELMAN, JENNA (PA)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:GUNSELMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:608 COMMONS DR
Practice Address - Street 2:SUITE A
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6349
Practice Address - Country:US
Practice Address - Phone:615-452-5901
Practice Address - Fax:615-451-2006
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-10
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA2937363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant