Healthcare Provider Details

I. General information

NPI: 1699225367
Provider Name (Legal Business Name): LAUREN BARRERA JUDKINS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ASHLEY BARRERA

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2377 FAIRVIEW BLVD
FAIRVIEW TN
37062-6003
US

IV. Provider business mailing address

5141 VIRGINIA WAY STE 390
BRENTWOOD TN
37027-9505
US

V. Phone/Fax

Practice location:
  • Phone: 615-799-0101
  • Fax:
Mailing address:
  • Phone: 615-933-7073
  • Fax: 615-988-1635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21893
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: