MEDICARE: MILDRED MAEGAN CLEMENTS 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	207Q00000X	Family Medicine Physician	40085	TN

General Provider Information

NPI Number	:	1487520490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILDRED MAEGAN CLEMENTS FNP-C

Provider Business Mailing Address
First Line	:	5725 MAGNOLIA WOODS DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-5445
Country	:	US
Telephone Number	:	901-846-6555
Fax Number	:

Provider Business Practice Location Address
First Line	:	8801 CHAFFEE RD
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-1545
Country	:	US
Telephone Number	:	901-846-6555
Fax Number	:

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

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	05/07/2026

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