Healthcare Provider Details
I. General information
NPI: 1144317660
Provider Name (Legal Business Name): TARA DAWN ATWOOD N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2009 BREWSTER DR
FRANKLIN TN
37067-8597
US
IV. Provider business mailing address
2009 BREWSTER DR
FRANKLIN TN
37067-8597
US
V. Phone/Fax
- Phone: 615-403-4527
- Fax: 615-250-3938
- Phone: 615-403-4527
- Fax: 615-250-3938
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 8030 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: