JACLYN BANE (NPI# 1871983452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871983452 |
| Entity Type | Individual |
| Full Name | JACLYN BANE |
| Practice Address |
587 Skyline Dr Jackson TN 38301-3938 |
| Mailing Address |
1804 Highway 45 Byp Ste 604 Jackson TN 38305-4403 |
| Practice Telephone | 7314248922 |
| Practice Fax Number | 7314232922 |
| Mailing Telephone | 7316607971 |
| Mailing Fax Number | 7316608739 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2018-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
19616 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 Jackson Walk Plz, Jackson, TN 383013008 | 7314248922 | 7314232922 |
| Street Address |
587 SKYLINE DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043437130 | The Medical Clinic of Jackson | Internal Medicine | 587 Skyline Dr, Jackson, TN 38301-3911 | 2007-04-19 |
| 1245890052 | Somer Lambert | Nurse Practitioner | 587 Skyline Dr, Jackson, TN 38301-3938 | 2019-06-14 |
| 1194285189 | Katie Alyse Johnson | Nurse Practitioner | 587 Skyline Dr, Jackson, TN 38301-3938 | 2019-03-25 |
| 1407351794 | Mimi Dill | Nurse Practitioner | 587 Skyline Dr, Jackson, TN 38301-3938 | 2018-03-28 |
| 1215175278 | Stacie K Grantham | Nurse Practitioner | 587 Skyline Dr, Jackson, TN 38301-3938 | 2009-01-29 |
| 1174773428 | Internal Medicine Clinic of Jackson Pllc | Clinic/Center | 587 Skyline Dr, Jackson, TN 38301-3938 | 2008-09-23 |
| 1629295738 | Robert H Dunnebacke | Internal Medicine | 587 Skyline Dr, Jackson, TN 38301-3911 | 2007-04-19 |
| 1235356361 | Conrado B Sioson Jr. | Internal Medicine | 587 Skyline Dr, Jackson, TN 38301-3911 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113627 | Jessicah Blasdel | Nurse Practitioner | 113 W Michigan Ave, Jackson, MI 49201-1340 | 2020-10-31 |
| 1801406335 | Jade Russell | Nurse Practitioner | 2205 W Morrell St, Jackson, MI 49203-1357 | 2020-08-10 |
| 1992315212 | Patrecia Campbell | Nurse Practitioner | 2570 Bailey Ave Ste 7, Jackson, MS 39213-6905 | 2020-08-01 |
| 1669008926 | Kristine Edwards | Nurse Practitioner | 723 Woodlawn Ave, Jackson, MI 49203-2921 | 2020-03-19 |
| 1295366391 | Christy White | Nurse Practitioner | 363 Old Pinson Rd, Jackson, TN 38301-9576 | 2020-01-28 |
| 1972141620 | Primary Care - Bemis, LLC | Nurse Practitioner | 1385 S Highland Ave Ste B4, Jackson, TN 38301-7547 | 2019-12-12 |
| 1174164263 | Tami Anne Miller | Nurse Practitioner | 124 N Bast St, Jackson, MO 63755-1704 | 2019-10-01 |
| 1265080584 | Cameron Nicole Howard | Nurse Practitioner | 1860 Chadwick Dr Ste 256, Jackson, MS 39204-3486 | 2019-08-29 |
| 1831750843 | Rhiannon Michelle Andresen | Nurse Practitioner | 1022 Greystone Sq, Jackson, TN 38305-3580 | 2019-06-21 |
| 1902376361 | Jenay B Krumm | Nurse Practitioner | 1201 E Michigan Ave Ste 200, Jackson, MI 49201-1855 | 2018-11-28 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.