Healthcare Provider Details

I. General information

NPI: 1871882431
Provider Name (Legal Business Name): CAROLYN YVONNE PULLEY NURSE PRACTITIONER,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THREE RIVERS COMMUNITY HEALTH 7723 CLEARVIEW CHURCH LANE
LYLES TN
37098
US

IV. Provider business mailing address

PERRY COUNTY MEDICAL CENTER 115 BROOKLYN AVENUE
LINDEN TN
37096
US

V. Phone/Fax

Practice location:
  • Phone: 931-670-5520
  • Fax: 931-670-5312
Mailing address:
  • Phone: 931-589-2104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number15548
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15548
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number158479
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: