Provider Demographics
NPI:1427450352
Name:PACHECO, JAMIE (CNM)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 MCFARLAND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3976
Mailing Address - Country:US
Mailing Address - Phone:423-492-7125
Mailing Address - Fax:865-374-1143
Practice Address - Street 1:609 MCFARLAND ST STE 201
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3976
Practice Address - Country:US
Practice Address - Phone:423-492-7125
Practice Address - Fax:865-374-1143
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13317348-4402363LX0001X
ID6561672367A00000X
TN39780367A00000X
SDCM000113367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ107009Medicaid