Healthcare Provider Details

I. General information

NPI: 1902700867
Provider Name (Legal Business Name): TAYLOR AMANDA LARSEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR AMANDA CARR APRN

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 LEBANON PIKE
HERMITAGE TN
37076-1475
US

IV. Provider business mailing address

226 SHIVEL DR
HENDERSONVILLE TN
37075-3540
US

V. Phone/Fax

Practice location:
  • Phone: 615-889-4864
  • Fax:
Mailing address:
  • Phone: 615-970-2760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number43127
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: