Healthcare Provider Details

I. General information

NPI: 1518835107
Provider Name (Legal Business Name): PHILOMENA MIKHAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MEDICAL CENTER PKWY
MURFREESBORO TN
37129-2245
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 800
NASHVILLE TN
37205-2221
US

V. Phone/Fax

Practice location:
  • Phone: 615-396-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6962
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: