Jackie A Church is a Kingsport, Tennessee based nurse practitioner with 19 years of experience in . She completed her graduation in 2006. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Jackie A Church is APN12537 for Family in Tennessee. Her current practice location is 4600 Fort Henry Dr, Kingsport. Patients can reach her at 423-224-3950. Jackie A Church is APN and her NPI number (Unique professional ID assigned by NPPES) is 1629126321. Jackie A Church has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Jackie A Church speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
Name:
Jackie A Church
Specialization:
Nurse Practitioner (NP)
Gender:
Female
Credentials:
APN
Experience:
19+ years
Medical School Attended:
Other
Graduation Year:
2006
Accepts Medicare Assignment:
Yes
Practice Address:
4600 Fort Henry Dr, Kingsport, Tennessee, 37663-2617
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
1153420195
Enrollment ID:
I20070615000550
NPI Number:
1629126321
NPI Enumeration Date:
08 Jan, 2007
NPI Last Update On:
18 Oct, 2023
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jackie A Church are as mentioned below.
License Number
Specialization
State
Status
APN12537
Family
Tennessee
Primary
143764
Registered Nurse
Tennessee
Secondary
0024187900
Nurse Practitioner
Virginia
Secondary
5018685
Nurse Practitioner
North Carolina
Secondary
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Jackie A Church is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Tri-cities Regional Emergency Physicians, Pc (3678859477)
132
Other Medical Identifiers:
Other legacy medical identifiers associated with Jackie A Church such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
P01171831
Other
Tennessee
RR MEDICARE
1629126321
Medicaid
North Carolina
1629126321
Medicaid
Virginia
3341016
Medicaid
Tennessee
7100236150
Medicaid
Kentucky
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Jackie A Church 1021 W Oakland Ave Ste 310, Johnson City, Tennessee
Zip:
37604-2192
Phone Number:
423-302-6565
Patients can reach Jackie A Church at 4600 Fort Henry Dr, Kingsport, Tennessee or can call to book an appointment on 423-224-3950.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.