Healthcare Provider Details
I. General information
NPI: 1487894093
Provider Name (Legal Business Name): PAMELA M PRESTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/23/2009
Last Update Date: 06/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2325 MEMORIAL BLVD
MURFREESBORO TN
37129-5108
US
IV. Provider business mailing address
8 CADILLAC DR SUITE 250
BRENTWOOD TN
37027-5087
US
V. Phone/Fax
- Phone: 615-225-0290
- Fax: 615-225-0296
- Phone: 615-425-4200
- Fax: 615-425-4271
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 6495 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: