Healthcare Provider Details

I. General information

NPI: 1487225819
Provider Name (Legal Business Name): EMILY ELROD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W BURTON ST
MURFREESBORO TN
37130-3657
US

IV. Provider business mailing address

8351 JACKSON RIDGE RD
ROCKVALE TN
37153-4268
US

V. Phone/Fax

Practice location:
  • Phone: 615-898-7880
  • Fax:
Mailing address:
  • Phone: 615-440-7448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number246132
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: