Jackson, Thomas E

Jackson, Thomas E is an individual health care provider with primary practice located at 2018 Western Ave , Knoxville TN 37921. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Jackson, Thomas E can be contacted via phone (865) 544-0406.

Contact Information

Primary practice address
2018 Western Ave Knoxville TN 37921
Phone: (865) 544-0406
Fax: (865) 544-0480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN72732 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN6129 Tennessee

Profile Details

NPI number 1366416042
LBN Legal business name Jackson, Thomas E
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366416042 NPPES
Tennessee MEDICAID 3642687

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