Search › Tennessee › 164W00000X
Jackie Johnson
NPI 1740516251 · on the registry since 2009
Practice
- Address
- 627 Smithview Dr
Maryville, TN 37803 - Phone
- (865) 380-4390
- Fax
- (865) 380-4396
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 164W00000X
164W00000X
- Licence states on file
- TN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2009-10-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee