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General NPI Number Information
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NPI Number | 1023986312
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Entity Type | Organization
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Legal Business Name | 3CW TN PLLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 103 SUNSET DR STE B
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City | MOUNT JULIET
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State | TN
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Zip | 37122-2968
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Country | US
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Telephone | 615-622-2442
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Fax |
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Provider Business Mailing Address
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Address Line | 103 SUNSET DR STE B
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City | MOUNT JULIET
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State | TN
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Zip | 37122-2968
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | LORI HOLMAN
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Credential |
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Telephone | 615-622-2442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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