Provider Demographics
NPI:1932995131
Name:KEITH, JENNIFER LEE (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:KEITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 PATRICIA ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-3819
Mailing Address - Country:US
Mailing Address - Phone:901-487-2757
Mailing Address - Fax:
Practice Address - Street 1:3315 PATRICIA ELLEN DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-3819
Practice Address - Country:US
Practice Address - Phone:901-487-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106611163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency