Individual provider · Type 1 NPI
Jack Monroe Visca
Surgical Physician Assistant · Crossville, TN
NPI number
1710829742
Active
Practice location
49 Cleveland St Ste 350
Crossville, TN 38555-2898
Mailing address
7331 Cresthill Dr Apt E5
Knoxville, TN 37919-5918
Other practice locations
- 421 S Main St, Crossville, TN 38555-5031 · (931) 484-9511
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 7121 (TN) |
| Medical Physician Assistant | 363AM0700X | 7121 (TN) |
Surgical Physician Assistant: Definition to come...
4 other providers at this address
Other surgical physician assistant providers in Crossville
About NPI 1710829742
Jack Monroe Visca's National Provider Identifier is 1710829742, issued on Apr 8, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Crossville, TN. The record was last updated on May 4, 2026.