MEDICARE: STACY PERKINS MCLALLEN NURSE PRACTITIONER

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	APN0000006155	TN

General Provider Information

NPI Number	:	1275547374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY PERKINS MCLALLEN NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1103 BILTMORE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	NP CARE OF TN, LLC
Second Line	:	2 INTERNATIONAL PLAZA SUITE 602
City	:	NASHVILLE
State	:	TN
Zip	:	37217-2017
Country	:	US
Telephone Number	:	615-366-1264
Fax Number	:	615-361-8932

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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