Healthcare Provider Details

I. General information

NPI: 1306783188
Provider Name (Legal Business Name): LYNN COREA PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 UPTOWN SQ
MURFREESBORO TN
37129-0573
US

IV. Provider business mailing address

5700 CEDAR ASH XING
ANTIOCH TN
37013-2346
US

V. Phone/Fax

Practice location:
  • Phone: 931-486-8670
  • Fax: 615-796-6911
Mailing address:
  • Phone: 931-486-8670
  • Fax: 615-796-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: