MEDICARE: AMY J BASS N P

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN0000008131	TN

General Provider Information

NPI Number	:	1013178383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY J BASS N P

Provider Business Mailing Address
First Line	:	1836 CROMWELL DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-5616
Country	:	US
Telephone Number	:	615-767-7507
Fax Number	:	615-309-9982

Provider Business Practice Location Address
First Line	:	1836 CROMWELL DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-5616
Country	:	US
Telephone Number	:	615-767-7507
Fax Number	:	615-309-9982

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	12/05/2016

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