DR. Nicole Beall Jaques, M.D.

NPI #1851563019 in Portland, Tennessee

Provider Information

NPI Number: 1851563019
Entity Type: Individual
Name: DR. Nicole Beall Jaques, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Mar 27, 2008
Last Updated: Jan 13, 2015

Practice Location

Address: 105 REDBUD DR
Address 2: EMERGENCY DEPARTMENT
City: Portland
State: Tennessee
ZIP Code: 37148-1673
Phone: (615) 745-8150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary
Emergency Medicine	207P00000X

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