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General NPI Number Information
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NPI Number | 1306154729
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Entity Type | Organization
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Legal Business Name | SUN-FORSYTHE, PLLC
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 545 E SPRING ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-3594
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Country | US
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Telephone | 615-598-8491
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Fax |
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Provider Business Mailing Address
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Address Line | 545 E SPRING ST
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City | COOKEVILLE
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State | TN
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Zip | 38501
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Country | US
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Telephone | 615-598-8491
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. RACHEL FORSYTHE
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Credential | ACNP-BC
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Telephone | 615-598-8491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APN0000013357
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License Number State | TN
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