Healthcare Provider Details

I. General information

NPI: 1023555828
Provider Name (Legal Business Name): ERIN ELIZABETH FAGOT APRN, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 STONECREST BLVD STE 310
SMYRNA TN
37167-6801
US

IV. Provider business mailing address

300 STONECREST BLVD STE 310
SMYRNA TN
37167-6801
US

V. Phone/Fax

Practice location:
  • Phone: 629-206-6858
  • Fax: 931-372-8839
Mailing address:
  • Phone: 629-206-6858
  • Fax: 931-372-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number22199
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: