Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHARLEY CROCKETT
ActiveCHARLEY CROCKETT is a Physician Assistant healthcare provider located in JACKSBORO, Tennessee. NPI 1376419960 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · JACKSBORO, TN
Registration Details
- NPI Number
- 1376419960
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 13, 2025 (0.69059952052375 yrs)
- Last Updated
- Jan 14, 2026
- License
-
6819 (TN)
Practice Information
- Address
-
2702 JACKSBORO PIKEJACKSBORO, TN, 377574850Browse TN providers · Browse ZIP 37757
- Phone
- 4233747775
- Fax
- 4233747779
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in JACKSBORO, TN
| Name | Credential | NPI |
|---|---|---|
| ANTHONY BAIRD | PA-C | 1104346667 |
| KALI RENEE RUTHERFORD | PA | 1164275566 |
| CHELSEA M THACKER | PA-C | 1124867130 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.