Healthcare Provider Details

I. General information

NPI: 1255532578
Provider Name (Legal Business Name): PATRICIA CAMERON MCLEOD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BLYTHEWOOD DR
COLUMBIA TN
38401-4828
US

IV. Provider business mailing address

6815 HIGHWAY 100 W
PLEASANTVILLE TN
37033-1864
US

V. Phone/Fax

Practice location:
  • Phone: 931-388-5757
  • Fax:
Mailing address:
  • Phone: 931-729-9702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0000152621
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: