Basic Information
Provider Information
NPI: 1386023737
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOOYEMA
FirstName: JACQUELYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 CRESCENT CENTRE DR STE 300
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370677285
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 326 NEW SHACKLE ISLAND RD STE 300
Address2:  
City: HENDERSONVILLE
State: TN
PostalCode: 370752302
CountryCode: US
TelephoneNumber: 6154480517
FaxNumber: 6154480518
Other Information
ProviderEnumerationDate: 05/19/2015
LastUpdateDate: 10/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X11404TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home