Healthcare Provider Details

I. General information

NPI: 1093375040
Provider Name (Legal Business Name): SCARLETT NOLAN MSN APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 MADISON ST STE B
CLARKSVILLE TN
37043-8043
US

IV. Provider business mailing address

3351 SHEFFIELD WAY
CLARKSVILLE TN
37043-7427
US

V. Phone/Fax

Practice location:
  • Phone: 931-503-7015
  • Fax:
Mailing address:
  • Phone: 931-320-0823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26073
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: