Basic Information
Provider Information
NPI: 1447797055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JENKINS
FirstName: MEGHAN
MiddleName: TOMLINSON
NamePrefix:  
NameSuffix:  
Credential: MSN, FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3024 BUSINESS PARK CIR
Address2:  
City: GOODLETTSVILLE
State: TN
PostalCode: 370723132
CountryCode: US
TelephoneNumber: 6158516033
FaxNumber: 6158512018
Practice Location
Address1: 3024 BUSINESS PARK CIR
Address2:  
City: GOODLETTSVILLE
State: TN
PostalCode: 370723132
CountryCode: US
TelephoneNumber: 6158516033
FaxNumber: 6158512018
Other Information
ProviderEnumerationDate: 01/21/2017
LastUpdateDate: 02/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X21940TNN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X21940TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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