Healthcare Provider Details

I. General information

NPI: 1134905342
Provider Name (Legal Business Name): MEREDITH FETTERMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 PRESIDENT PL STE 20
SMYRNA TN
37167-6807
US

IV. Provider business mailing address

741 PRESIDENT PL STE 200
SMYRNA TN
37167-6809
US

V. Phone/Fax

Practice location:
  • Phone: 615-459-7104
  • Fax:
Mailing address:
  • Phone: 615-459-7104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number34548
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: