Healthcare Provider Details

I. General information

NPI: 1790847358
Provider Name (Legal Business Name): KIMBERLY R PRICHARD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5148A MURFREESBORO RD
LA VERGNE TN
37086-2712
US

IV. Provider business mailing address

5148A MURFREESBORO RD
LA VERGNE TN
37086-2712
US

V. Phone/Fax

Practice location:
  • Phone: 615-213-2273
  • Fax: 615-213-2271
Mailing address:
  • Phone: 615-213-2273
  • Fax: 615-213-2271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000006625
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: