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NPI Code Detail

MEDICARE: STATE OF TENNESSEE

MEDICARE: STATE OF TENNESSEE
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
1251K00000XPublic Health or Welfare AgencyTN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366595134
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF TENNESSEE
Provider Business Mailing Address
First Line : 108 DAVID COLLINS DR
Second Line :
City : SMYRNA
State : TN
Zip : 37167-2813
Country : US
Telephone Number : 615-355-6175
Fax Number : 615-459-7996
Provider Business Practice Location Address
First Line : 108 DAVID COLLINS DR
Second Line :
City : SMYRNA
State : TN
Zip : 37167-2813
Country : US
Telephone Number : 615-355-6175
Fax Number : 615-459-7996
Authorized Official
Title or Position : REGIONAL DIRECTOR
Name : MRS. ANNETTE HALEY
Credential :
Telephone Number : 615-650-7000
Provider Enumeration Date : 01/18/2007
Last Update Date : 08/24/2010

Similar Medicare Providers

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Practice Location Address:
108 DAVID COLLINS DR
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1285728808 — MS. CYNTHIA RENEE DEMONBREUM NURSE PRACTITIONER
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1861529414 — MRS. CATHERINE RACHEL REYNOLDS RN
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1720201064 — LUANN P. SHEPPERD RN
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1750504098 — TINA R. RICE RN
Practice Location Address:
108 DAVID COLLINS DR
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1336648534 — MELISSA MARIE HASTINGS REGISTERED NURSE
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Directions to “STATE OF TENNESSEE ” Practice Location

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