Most Relevant Information
Provider Data
| NPI Number: | 1003664293 |
| Provider Name: | JENNY LYNNA' GIBBS HALL AG-ANCP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | APN00000027363 |
Most Important Dates
| Enumeration Date: | 05/11/2024 |
| Last Updated: | 05/11/2024 |
Provider Practice Location
704 PINNACLE HILL RD
KINGSTON SPRINGS
TN
370829212
Practice Location Phone/Fax
| Phone: | 6159458890 |
| Fax: | 6159524870 |
Provider Mailing Location
704 PINNACLE HILL RD
KINGSTON SPRINGS
TN
370829212
Provider Mailing Phone/Fax
| Phone: | 6159458890 |
| Fax: | 6159524870 |