Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaci Kate Qualls, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1194536367

Jaci Kate Qualls, FNP-BC is a Nurse Practitioner in Livingston, Tennessee. Qualified in 2024, 2 years ago. Practices with John R Clough, an 8-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
2
Licensed in
TN
In the registry since
2025
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

5751 Bradford Hicks Dr
Livingston, TN 38570-2237
Phone: (931) 823-3030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 38006 (TN)

Record details

NPI number1194536367
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJanuary 16, 2025
Last updated in NPPESJanuary 16, 2025
Certification dateDecember 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice John R Clough — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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