Healthcare Provider Details

I. General information

NPI: 1306872007
Provider Name (Legal Business Name): STACY PIPER SANDERS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 LIBERTY PIKE
FRANKLIN TN
37067-5608
US

IV. Provider business mailing address

1012 VIOLET ST
SPRING HILL TN
37174-2239
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 612-659-7101
Mailing address:
  • Phone: 615-400-4671
  • Fax: 612-659-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN11760
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: