Healthcare Provider Details

I. General information

NPI: 1588256051
Provider Name (Legal Business Name): DAWN MICHELLE WRAY MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2021
Last Update Date: 02/06/2021
Certification Date: 02/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 OLD CLARKSVILLE PIKE
JOELTON TN
37080-8818
US

IV. Provider business mailing address

3712 OLD CLARKSVILLE PIKE
JOELTON TN
37080-8818
US

V. Phone/Fax

Practice location:
  • Phone: 615-708-9273
  • Fax:
Mailing address:
  • Phone: 615-708-9273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF01211222
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: