person
Kenneth S Jackson, FNP
Family Nurse Practitioner in Bruceton, Tennessee
NPI 1811237001

Kenneth S Jackson is a Family Nurse Practitioner based in Mc Kenzie, TN and is specialized in Family. Kenneth S Jackson practices in Bruceton, TN and has the professional credentials of FNP. The NPI Number for Kenneth S Jackson is 1811237001 and holds a License No. 17382 (Tennessee).

The current practice location address for Kenneth S Jackson is 123 Maple St, Bruceton, TN and can be reached out via phone at 731-586-4800 and via fax at 731-352-4459.

Location: 123 Maple St, Bruceton, TN, 38201-1649
person
Provider Profile Details
NPI Number
1811237001
Provider Name
Kenneth S Jackson
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
123 Maple St, Bruceton, TN, 38201-1649
Phone Number
731-586-4800
Fax Number
731-352-4459
Provider Enumeration Date
02/25/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3380640 01 TN GROUP MEDICAID
3380640 01 TN GROUP MEDICARE
10350I2435 01 TN MEDICARE PTAN
Q001235 05 TN
institution
Provider Business Practice Location Address Details
Address
123 Maple St
City
State
Zip
38317-1819
Phone Number
731-586-4800
Fax Number
731-352-4459
person
Provider Business Mailing Address Details
Address
123 Maple St
City
State
Zip
38317-1819
Phone Number
731-586-4800
Fax Number
731-352-4459
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
17382 (Tennessee)
Definition
Definition to come...
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