MEDICARE: LAUREN MICHELLE FOX FNP-C

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	163W00000X	Registered Nurse	RN0000191215	TN
2	363LF0000X	Family Nurse Practitioner	APN0000027184	TN

General Provider Information

NPI Number	:	1255952065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MICHELLE FOX FNP-C

Provider Business Mailing Address
First Line	:	2276 WICKERSHAM CV
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-5114
Country	:	US
Telephone Number	:	601-613-9561
Fax Number	:

Provider Business Practice Location Address
First Line	:	3638 MACON RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-2209
Country	:	US
Telephone Number	:	901-209-0195
Fax Number	:

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

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	05/04/2020

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