Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Miller Pendergrass, AG-ACNP

Individual provider Acute Care Nurse Practitioner · NPI 1629475348

Mallory Miller Pendergrass, AG-ACNP is an Acute Care Nurse Practitioner in Jackson, Tennessee. Licensed in Tennessee. Registered with an NPI since 2014.

Licensed in
TN
In the registry since
2014

Practice location Address checks out

620 Skyline Dr
Jackson, TN 38301-3923
Phone: (731) 541-6900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 19221 (TN)

Record details

NPI number1629475348
Entity typeIndividual (Type 1)
GenderFemale
Credentials AG-ACNP
Sole proprietorNo
NPI enumeratedNovember 24, 2014
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025

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