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General NPI Number Information
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NPI Number | 1063160489
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Entity Type | Individual
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Provider Name | NATHAN W NAILS A.P.R.N.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 145 INNOVATION DR
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City | JACKSON
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State | TN
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Zip | 38305-3019
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Country | US
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Telephone | 731-422-0213
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Fax | 731-422-0409
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | JACKSON
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State | TN
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Zip | 38302-0400
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Country | US
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Telephone | 731-425-5752
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Fax | 731-425-5783
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 217742
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 31565
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 31565
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 31565
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 31565
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 31565
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 31565
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 31565
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License Number State | TN
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Taxonomy #9
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 31565
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License Number State | TN
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