=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336998665
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAIGE LAMPHIER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2024
-----------------------------------------------------
Last Update Date | 05/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9400 RHEA COUNTY HWY
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37321-7922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-775-8552
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6844 COOLEY RD
-----------------------------------------------------
City | OOLTEWAH
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37363-5740
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 34529
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------