Jessica Jean Godsey, LPN

Individual provider Active NPI Licensed Practical Nurse · Harriman, TN

NPI 1770280596 · NPPES record last updated Feb 13, 2023

Key facts

NPI
1770280596
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
0000067631 (TN)
Practice address
326 Washington Dr
Harriman, TN 37748-6202
Phone
(865) 313-6783
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0000067631TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0000067631 TN Yes

Addresses

Primary practice location

326 Washington Dr
Harriman, TN 37748-6202

Mailing address

326 Washington Dr
Harriman, TN 37748-6202
Phone (865) 313-6783

Other providers in Harriman, TN

All providers in Harriman, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.