Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MALLORY MILLER PENDERGRASS, AG-ACNP
ActiveMALLORY MILLER PENDERGRASS, AG-ACNP is a Acute Care Nurse Practitioner healthcare provider located in JACKSON, Tennessee. NPI 1629475348 is currently active in the NPPES registry. Verify at CMS.
Acute Care Nurse Practitioner · JACKSON, TN
Registration Details
- NPI Number
- 1629475348
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 24, 2014 (11.53481326535 yrs)
- Last Updated
- Jul 21, 2025
- License
-
19221 (TN)
Practice Information
- Address
-
620 SKYLINE DRJACKSON, TN, 383013923Browse TN providers · Browse ZIP 38301
- Phone
- 7315416900
- Primary Specialty
-
Acute Care Nurse Practitioner
363LA2100X
Other Acute Care Nurse Practitioner Providers in JACKSON, TN
| Name | Credential | NPI |
|---|---|---|
| STACEY S HODGES | ACNP | 1104814805 |
| MRS. ENJA O HOLLAND | ACNP | 1720317191 |
| LEIGH ANN BRANDEBERRY | APN | 1750786018 |
| NICHOLAS ARCHER | — | 1760934855 |
| PAULA DENISE TEDIN-MOSCHOVAS | DNP, ACNP-BC | 1265960751 |
| TERESA FOWLER | DNP | 1649942236 |
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.