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NPI Code Detail

MEDICARE: MR. BRYON RANDOLPH JR. FNP-BC

MEDICARE: MR. BRYON RANDOLPH JR. 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 Practitioner40466TN

General Provider Information

NPI Number : 1326934555
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYON RANDOLPH JR. FNP-BC
Provider Business Mailing Address
First Line : 1272 GARRISON DR
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-2598
Country : US
Telephone Number : 615-867-8010
Fax Number :
Provider Business Practice Location Address
First Line : 1272 GARRISON DR
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-2598
Country : US
Telephone Number : 615-971-8773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2025
Last Update Date : 01/15/2026

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Directions to “ MR. BRYON RANDOLPH JR. FNP-BC” Practice Location

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