Healthcare Provider Details

I. General information

NPI: 1033368543
Provider Name (Legal Business Name): STEPHANIE DAVIS NIPPER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 06/12/2022
Certification Date: 06/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N HIGHLAND AVE
MURFREESBORO TN
37130-2494
US

IV. Provider business mailing address

1307 CHELMSFORD CT
MURFREESBORO TN
37128-4584
US

V. Phone/Fax

Practice location:
  • Phone: 615-396-6620
  • Fax: 615-396-6625
Mailing address:
  • Phone: 615-400-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number64415
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number160208
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1128
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15657
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: