Healthcare Provider Details

I. General information

NPI: 1548719313
Provider Name (Legal Business Name): LAUREN MICHELLE GRUDE WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SEABOARD LN STE A10
FRANKLIN TN
37067-8221
US

IV. Provider business mailing address

2101 YELLOW CREEK RD
DICKSON TN
37055-5235
US

V. Phone/Fax

Practice location:
  • Phone: 615-326-9918
  • Fax: 779-201-6241
Mailing address:
  • Phone: 615-613-7361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number21819
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number21819
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: