Provider Demographics
NPI:1609589431
Name:CARTWRIGHT, JACEY
Entity type:Individual
Prefix:
First Name:JACEY
Middle Name:
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1494 OLD NASHVILLE DIRT RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-5536
Mailing Address - Country:US
Mailing Address - Phone:931-619-6849
Mailing Address - Fax:
Practice Address - Street 1:1494 OLD NASHVILLE DIRT RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-5536
Practice Address - Country:US
Practice Address - Phone:931-619-6849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant