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NPI Code Detail

MEDICARE: NAN M. GAYLORD PHD, RN, CPNP

MEDICARE: NAN M. GAYLORD PHD, RN, CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN0000044603TN
2363LP0200XPediatric Nurse PractitionerAPN0000005409TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013911007
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAN M. GAYLORD PHD, RN, CPNP
Provider Business Mailing Address
First Line : 1200 VOLUNTEER BLVD
Second Line : UTCON #335
City : KNOXVILLE
State : TN
Zip : 37996-4180
Country : US
Telephone Number : 865-974-7622
Fax Number : 865-974-3569
Provider Business Practice Location Address
First Line : 220 LANGLAND ST
Second Line :
City : KNOXVILLE
State : TN
Zip : 37915-1415
Country : US
Telephone Number : 865-594-5078
Fax Number : 865-594-3921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 08/03/2011

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