MEDICARE: BRUCE E MCLAUGHLIN NP

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
1	363LF0000X	Family Nurse Practitioner	7148	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4082560	OTHER	TN	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1225060999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE E MCLAUGHLIN NP

Provider Business Mailing Address
First Line	:	754 N MOUNT JULIET RD
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-3323
Country	:	US
Telephone Number	:	615-754-2828
Fax Number	:	615-754-2818

Provider Business Practice Location Address
First Line	:	754 N MOUNT JULIET RD
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-3323
Country	:	US
Telephone Number	:	615-754-2828
Fax Number	:	615-754-2818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/08/2011

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