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NPI Code Detail

MEDICARE: JANE SMITH DUBOSE APRN, BC

MEDICARE: JANE SMITH DUBOSE APRN, BC
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 Practitioner0000005932TN

General Provider Information

NPI Number : 1720072770
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE SMITH DUBOSE APRN, BC
Provider Business Mailing Address
First Line : 2531 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3154
Country : US
Telephone Number : 615-883-6995
Fax Number :
Provider Business Practice Location Address
First Line : 2531 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3154
Country : US
Telephone Number : 615-883-6995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 02/06/2013

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