MEDICARE: CHRISTY LYN PETR

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	363L00000X	Nurse Practitioner	257977	TN

General Provider Information

NPI Number	:	1861127029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY LYN PETR

Provider Business Mailing Address
First Line	:	200 JAMES ROBERTSON PKWY
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 JAMES ROBERTSON PKWY
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1202
Country	:	US
Telephone Number	:	615-862-8123
Fax Number	:

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

Provider Enumeration Date	:	07/21/2022
Last Update Date	:	07/21/2022

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