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NPI Code Detail

MEDICARE: RACHEL LOUISE WIDRICK FNP

MEDICARE:   RACHEL LOUISE WIDRICK  FNP
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
1363LF0000XFamily Nurse Practitioner29967TN

General Provider Information

NPI Number : 1396418992
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL LOUISE WIDRICK FNP
Provider Business Mailing Address
First Line : 120 PROVIDENCE TRL APT 5314
Second Line :
City : MT JULIET
State : TN
Zip : 37122-6531
Country : US
Telephone Number : 607-240-9443
Fax Number :
Provider Business Practice Location Address
First Line : 200 CHURCH ST
Second Line :
City : NASHVILLE
State : TN
Zip : 37201-1613
Country : US
Telephone Number : 615-284-8194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2021
Last Update Date : 07/29/2021

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Directions to “ RACHEL LOUISE WIDRICK FNP” Practice Location

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