Provider Demographics
NPI:1386319630
Name:INGLE, JAMIE DANELLE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:DANELLE
Last Name:INGLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 STAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND FURNACE
Mailing Address - State:TN
Mailing Address - Zip Code:37051-4515
Mailing Address - Country:US
Mailing Address - Phone:615-326-2389
Mailing Address - Fax:
Practice Address - Street 1:111 HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2080
Practice Address - Country:US
Practice Address - Phone:615-326-2389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily