Healthcare Provider Details

I. General information

NPI: 1396012399
Provider Name (Legal Business Name): PATRICIA M POWERS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 02/09/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2557 HIGHWAY 41 S
GREENBRIER TN
37073-5516
US

IV. Provider business mailing address

2557 HIGHWAY 41 S
GREENBRIER TN
37073-5516
US

V. Phone/Fax

Practice location:
  • Phone: 615-643-9015
  • Fax: 615-643-4537
Mailing address:
  • Phone: 615-643-9015
  • Fax: 615-643-4537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115265
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: