Healthcare Provider Details

I. General information

NPI: 1609754589
Provider Name (Legal Business Name): MEAGAN NICOLLE CARVER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9025 US HIGHWAY 64
LAKELAND TN
38002-7981
US

IV. Provider business mailing address

5241 JON OAK DR
ARLINGTON TN
38002-5061
US

V. Phone/Fax

Practice location:
  • Phone: 901-387-2998
  • Fax:
Mailing address:
  • Phone: 901-606-5128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39793
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: