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Jenny R Stevens

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2100 Clinch Ave, Suite 110, Knoxville, TN 37916

PECOS Enrollment

This provider is enrolled in PECOS as JENNY STEVENS.

Based on the most recent information from CMS, provider Jenny R Stevens is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:00 AM.

Profile Details

Provider ID
1679003461
Provider Type
Individual
Full Name
Stevens, Jenny R
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
6/14/2017
Last Updated
12/21/2023

Contact Information

Practice Location

2100 Clinch Ave, Suite 110, Knoxville, TN 37916

(865) 524-1869

Unlisted Fax

Mailing Location

2100 Clinch Ave, Suite 110, Knoxville, TN 37916-2223

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 20262 Tennessee

Provider Identifiers

ID	Description	Issuer
ID Q030088	Description Medicaid	Issuer Unlisted Tennessee

Jenny R Stevens

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Greer, Erick A

Efflandt, Zhanna Yurievna

Loop, Amy

Laskowski, Cassandra J

Taylor, Erik

Rosson, Jennifer

Pickel, Kimberly Jo

Hairell, Ryan Keith

Haun, Ashley L