Healthcare Provider Details

I. General information

NPI: 1104098748
Provider Name (Legal Business Name): CPR4ME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 MURFREESBORO PIKE
NASHVILLE TN
37217-2440
US

IV. Provider business mailing address

1218 MURFREESBORO PIKE
NASHVILLE TN
37217-2440
US

V. Phone/Fax

Practice location:
  • Phone: 615-367-1968
  • Fax: 615-367-1968
Mailing address:
  • Phone: 615-367-1968
  • Fax: 615-367-1968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateTN

VIII. Authorized Official

Name: MS. THERESA DALE BLAIR
Title or Position: OWNER
Credential: R.N
Phone: 931-215-6942