Healthcare Provider Details

I. General information

NPI: 1881009769
Provider Name (Legal Business Name): JULIE PICKERING APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 GALLATIN PIKE S
MADISON TN
37115-4613
US

IV. Provider business mailing address

1005 17TH AVE S STE 810
NASHVILLE TN
37212-2270
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 401-652-9787
Mailing address:
  • Phone: 844-251-2638
  • Fax: 401-652-9787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number905665
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18848
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: