Healthcare Provider Details

I. General information

NPI: 1467340703
Provider Name (Legal Business Name): COURTNEY PAMPLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 8TH ST
CLARKSVILLE TN
37040-3093
US

IV. Provider business mailing address

4700 ALBRIGHT RD
CLARKSVILLE TN
37043-7704
US

V. Phone/Fax

Practice location:
  • Phone: 931-920-7200
  • Fax:
Mailing address:
  • Phone: 931-291-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number268775
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: