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JELLICO WELLNESS BEHAVIORAL HEALTH
NPI 1952805319
Nurse Practitioner - Psychiatric/Mental Health in Jellico, TN

Active since March 21, 2018
1811 5TH ST, JELLICO, TN 37762(615) 335-3430 Get Directions Write a Review

NPPES record last updated: September 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2024, Feb 17, 2022, Mar 21, 2018 (3 updates tracked since 2018).

About Jellico Wellness Behavioral Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JELLICO WELLNESS BEHAVIORAL HEALTH (NPI 1952805319) is a healthcare organization registered as a psychiatric/mental health in Jellico, Tennessee and active in the NPI registry since March 2018. The organization lists Nicole Asante, Fnp/president, as its authorized official.

NPPES Registry Identity

NPI1952805319
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameJELLICO WELLNESS AND CONVENIENT CARE CLINIC, LLC
Location Address1811 5TH STJellico, TN 37762-4629
Mailing Address1811 5th StJellico, TN 37762-4629 · (423) 455-3032 · Fax (423) 455-3042
Phone(615) 335-3430
Organization SubpartNo
Authorized OfficialNicole AsanteFnp/president · (615) 335-3430
Enumeration DateMarch 21, 2018
Last NPPES UpdateSeptember 5, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2024
✔ NPI 1952805319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 14174 (TN)
1811 5TH ST, Jellico, TN 37762
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Other Names 1

Doing Business AsJellico Wellness Behavioral Health

Other Identifiers 2

Medicaid1527342TN
Other1031508098TN · Medicare

Group Practice 2

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE ANN ASANTE FNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1811 5TH ST
JELLICO, TN 37762
Campbell County (423) 455-3032

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jellico Wellness And Convenient Care Clinic, LLC's NPI number?

The NPI number for Jellico Wellness And Convenient Care Clinic, LLC is 1952805319. It was assigned to this organization in the NPPES registry on March 21, 2018. The provider is doing business as Jellico Wellness Behavioral Health.

Where is Jellico Wellness And Convenient Care Clinic, LLC located?

Jellico Wellness And Convenient Care Clinic, LLC is located at 1811 5th St, Jellico, TN 37762. The listed phone number is (615) 335-3430.

What is Jellico Wellness And Convenient Care Clinic, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Jellico Wellness And Convenient Care Clinic, LLC was last updated on September 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.