Healthcare Provider Details

I. General information

NPI: 1285185835
Provider Name (Legal Business Name): CAMEREN J HACKLEY ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 GALLATIN PIKE N
MADISON TN
37115-2001
US

IV. Provider business mailing address

2009 GALLATIN PIKE N
MADISON TN
37115-2001
US

V. Phone/Fax

Practice location:
  • Phone: 615-988-4055
  • Fax: 877-721-6419
Mailing address:
  • Phone: 615-988-4055
  • Fax: 877-721-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number40606
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: