Provider Demographics
NPI:1417793183
Name:MCNEESE, JAYCEY ANNETTE (FNP- C)
Entity type:Individual
Prefix:
First Name:JAYCEY
Middle Name:ANNETTE
Last Name:MCNEESE
Suffix:
Gender:F
Credentials:FNP- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 MCKIBBON LN
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3117
Mailing Address - Country:US
Mailing Address - Phone:931-309-9757
Mailing Address - Fax:
Practice Address - Street 1:1503 HATCHER LN STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4833
Practice Address - Country:US
Practice Address - Phone:931-236-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily