Provider Demographics
NPI:1194099358
Name:SHETTERS, JENNIFER ARCHEY (APN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ARCHEY
Last Name:SHETTERS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2208
Mailing Address - Country:US
Mailing Address - Phone:931-455-2045
Mailing Address - Fax:931-455-9960
Practice Address - Street 1:601 NW ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3536
Practice Address - Country:US
Practice Address - Phone:931-393-2245
Practice Address - Fax:931-393-2247
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000016420363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health