Healthcare Provider Details

I. General information

NPI: 1427653898
Provider Name (Legal Business Name): MEGAN RAY HUFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 01/10/2023
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 EASTGATE BLVD STE 104
LEBANON TN
37090-6018
US

IV. Provider business mailing address

6650 EASTGATE BLVD STE 104
LEBANON TN
37090-6018
US

V. Phone/Fax

Practice location:
  • Phone: 615-900-5451
  • Fax:
Mailing address:
  • Phone: 615-900-5451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number237112
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32675
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: