Healthcare Provider Details

I. General information

NPI: 1013858836
Provider Name (Legal Business Name): VANCE ALFORD ADGENT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 GARRISON DR
MURFREESBORO TN
37129-2570
US

IV. Provider business mailing address

2641 FOREST RUN DR
LEWISBURG TN
37091-7300
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-4480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number42395
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: