Jeannetta S Brophy, RN

Individual provider Active NPI Community Health Registered Nurse · Jasper, TN

NPI 1912453036 · NPPES record last updated Nov 8, 2022

Key facts

NPI
1912453036
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
186165 (TN)
Practice address
24 E 7TH St
Jasper, TN 37347-3301
Phone
(423) 942-2238
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
186165TNMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 186165 TN Yes

Addresses

Primary practice location

24 E 7TH St
Jasper, TN 37347-3301

Mailing address

24 E 7TH St
Jasper, TN 37347-3301
Phone (423) 827-8593

Other providers in Jasper, TN

All providers in Jasper, TN · Community Health Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.