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NPI Code Detail

MEDICARE: MR. SCOTT BLAIR COFFEY FNP-BC

MEDICARE: MR. SCOTT BLAIR COFFEY FNP-BC
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
1363LF0000XFamily Nurse Practitioner15007TN

General Provider Information

NPI Number : 1205155165
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT BLAIR COFFEY FNP-BC
Provider Business Mailing Address
First Line : 317 BRANDIWOOD CT
Second Line :
City : OLD HICKORY
State : TN
Zip : 37138-4219
Country : US
Telephone Number : 615-305-6946
Fax Number :
Provider Business Practice Location Address
First Line : 1412 COUNTY HOSPITAL RD
Second Line :
City : NASHVILLE
State : TN
Zip : 37218-3007
Country : US
Telephone Number : 615-687-3611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2010
Last Update Date : 08/02/2010

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