Healthcare Provider Details

I. General information

NPI: 1750766382
Provider Name (Legal Business Name): EMILY SHAYE FITZPATRICK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
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:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPN0000020101
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN0000020101
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: