Provider Demographics
NPI:1427337609
Name:CHRISTIE, JESSICA DAWN (CNA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:DAWN
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:DAWN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:11998 NASHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-5150
Mailing Address - Country:US
Mailing Address - Phone:931-205-3217
Mailing Address - Fax:
Practice Address - Street 1:1401 SPARTA ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1301
Practice Address - Country:US
Practice Address - Phone:931-473-8468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94961376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide