MEDICARE: LOREL S HEDGES MS, ANP, BC, ACHPN

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	363LA2200X	Adult Health Nurse Practitioner	20297	TN

General Provider Information

NPI Number	:	1376855650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOREL S HEDGES MS, ANP, BC, ACHPN

Provider Business Mailing Address
First Line	:	169 PRIVATEER LN
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-2574
Country	:	US
Telephone Number	:	312-933-9138
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 PRIVATEER LN
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-2574
Country	:	US
Telephone Number	:	312-933-9138
Fax Number	:

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

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	02/01/2017

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