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1396481693
MYCAH JACK
KNOXVILLE, TN
NPI
1396481693
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN 31108)
Enumeration Date
2022-05-09
Last Update Date
2022-05-09
Business Address
MYCAH JACK FNP-BC
1930 ALCOA HWY
KNOXVILLE, TN 37920-1500
Phone number: 865-263-2400
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Mailing Address
MYCAH JACK FNP-BC
4209 DEERFIELD RD
KNOXVILLE, TN 37921-3219
Phone number: 865-313-3709
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