Healthcare Provider Details

I. General information

NPI: 1508225319
Provider Name (Legal Business Name): PHILIP ANDREW MCCAIN MSN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 TYSON AVE
PARIS TN
38242-4544
US

IV. Provider business mailing address

183 CARMEN DR
PARIS TN
38242-7083
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-1220
  • Fax:
Mailing address:
  • Phone: 731-499-2430
  • Fax: 731-644-8497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20932
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: