Healthcare Provider Details

I. General information

NPI: 1730268319
Provider Name (Legal Business Name): ANITA ROCHELLE PINKSTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MEDICAL CENTER PKWY SUITE 410
MURFREESBORO TN
37129-2567
US

IV. Provider business mailing address

1800 MEDICAL CENTER PKWY SUITE 410
MURFREESBORO TN
37129-2567
US

V. Phone/Fax

Practice location:
  • Phone: 615-396-6800
  • Fax: 615-396-6801
Mailing address:
  • Phone: 615-396-6800
  • Fax: 615-396-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number586
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA0000000586
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: