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General NPI Number Information
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NPI Number | 1790304368
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Entity Type | Individual
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Provider Name | CAROLINE FULLER PRESCOTT M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 95 SEABOARD LN STE 2021
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City | BRENTWOOD
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State | TN
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Zip | 37027-3031
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Country | US
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Telephone | 615-261-1210
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Fax | 833-973-3532
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Provider Business Mailing Address
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Address Line | PO BOX 26194
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City | BELFAST
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State | ME
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Zip | 04915-2012
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Country | US
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Telephone | 865-584-4747
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Fax | 865-212-3718
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 67597
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License Number State | TN
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