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NPI Code Detail

MEDICARE: MRS. SHELLEY CRUMP HARDEMAN PTA

MEDICARE: MRS. SHELLEY CRUMP HARDEMAN PTA
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
1225200000XPhysical Therapy Assistant0000002004TN

General Provider Information

NPI Number : 1033291752
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHELLEY CRUMP HARDEMAN PTA
Provider Business Mailing Address
First Line : 1040 PARKWOOD TER
Second Line :
City : NASHVILLE
State : TN
Zip : 37220-1417
Country : US
Telephone Number : 615-370-8920
Fax Number :
Provider Business Practice Location Address
First Line : 211 BEDFORD WAY
Second Line :
City : FRANKLIN
State : TN
Zip : 37064-5527
Country : US
Telephone Number : 615-591-8480
Fax Number : 615-791-0989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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