Healthcare Provider Details

I. General information

NPI: 1366156028
Provider Name (Legal Business Name): TN WOMENS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 HIGHWAY 52 BYP W
LAFAYETTE TN
37083-2685
US

IV. Provider business mailing address

641 HIGHWAY 52 BYP W
LAFAYETTE TN
37083-2685
US

V. Phone/Fax

Practice location:
  • Phone: 615-622-6631
  • Fax: 877-550-1906
Mailing address:
  • Phone: 615-622-6631
  • Fax: 877-550-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHAYE FITZPATRICK
Title or Position: OWNER/PROVIDER
Credential:
Phone: 615-655-2920