=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336821214
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE DEMPSEY APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2023
-----------------------------------------------------
Last Update Date | 08/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 585 INTERSTATE DR STE B
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37355-3191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-728-9000
-----------------------------------------------------
Fax | 931-728-2726
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 585 INTERSTATE DR STE B
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37355-3191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-728-9000
-----------------------------------------------------
Fax | 931-728-2726
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 34447
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 218303
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------