Healthcare Provider Details

I. General information

NPI: 1952564593
Provider Name (Legal Business Name): CHERYL LANDIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 BEDFORD WAY
FRANKLIN TN
37064
US

IV. Provider business mailing address

206 BEDFORD WAY
FRANKLIN TN
37064
US

V. Phone/Fax

Practice location:
  • Phone: 615-790-3290
  • Fax: 615-794-8845
Mailing address:
  • Phone: 615-790-3290
  • Fax: 615-794-8845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number146708
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: