Healthcare Provider Details

I. General information

NPI: 1487916524
Provider Name (Legal Business Name): KENDRA DAWN METHVIN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 N LOCUST AVE
LAWRENCEBURG TN
38464-3516
US

IV. Provider business mailing address

326 N LOCUST AVE
LAWRENCEBURG TN
38464-3516
US

V. Phone/Fax

Practice location:
  • Phone: 931-762-9797
  • Fax: 931-762-9798
Mailing address:
  • Phone: 931-762-9797
  • Fax: 931-762-9798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16639
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number141643
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: