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General NPI Number Information
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NPI Number | 1629684568
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Entity Type | Individual
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Provider Name | KATHRYN ANN VAGO APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 1547 WARRIOR DR
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City | MURFREESBORO
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State | TN
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Zip | 37128-0921
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Country | US
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Telephone | 615-294-4341
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 CROSSINGS BLVD
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City | ANTIOCH
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State | TN
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Zip | 37013-3130
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Country | US
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Telephone | 615-941-4820
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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 | 27299
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License Number State | TN
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