Healthcare Provider Details

I. General information

NPI: 1346287901
Provider Name (Legal Business Name): NANCY A. ARMETTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 REDBUD LN
WAYNESBORO TN
38485-5047
US

IV. Provider business mailing address

126 REDBUD LN P.O. BOX 937
WAYNESBORO TN
38485-5047
US

V. Phone/Fax

Practice location:
  • Phone: 931-722-5677
  • Fax: 931-722-2236
Mailing address:
  • Phone: 931-722-5677
  • Fax: 931-722-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD016688
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2013-01400
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: