Healthcare Provider Details

I. General information

NPI: 1871421255
Provider Name (Legal Business Name): COLLECTIVE SALON AND SPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 COWAN HWY
WINCHESTER TN
37398-2446
US

IV. Provider business mailing address

2090 COWAN HWY
WINCHESTER TN
37398-2446
US

V. Phone/Fax

Practice location:
  • Phone: 931-229-6569
  • Fax:
Mailing address:
  • Phone: 931-229-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: NATALIE HOLLIS CLEM
Title or Position: OWNER/NP
Credential:
Phone: 931-409-8079