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General NPI Number Information
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NPI Number | 1316432602
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Entity Type | Individual
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Provider Name | TERA JEANETTE SIMPSON FNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 200 STONECREST BLVD
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City | SMYRNA
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State | TN
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Zip | 37167
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Country | US
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Telephone | 615-768-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1013 BELMONT DR
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City | DICKSON
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State | TN
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Zip | 37055-6102
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Country | US
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Telephone | 615-557-8846
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24482
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 139722
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License Number State | TN
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