Provider Demographics
NPI:1730461666
Name:ZGIET, JACQUELINE S (NP)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:S
Last Name:ZGIET
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 VILLAGE LN STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-2948
Mailing Address - Country:US
Mailing Address - Phone:682-900-6631
Mailing Address - Fax:682-503-7500
Practice Address - Street 1:10904 KINGSTON PIKE STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2952
Practice Address - Country:US
Practice Address - Phone:469-991-7647
Practice Address - Fax:682-503-7500
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN16115363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health