MEDICARE: MS. GRACEY SANDERSON

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	163W00000X	Registered Nurse	289141	TN

General Provider Information

NPI Number	:	1376479857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GRACEY SANDERSON

Provider Business Mailing Address
First Line	:	2350 8TH AVE S APT 1-406
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-2280
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 MURFREESBORO PIKE
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-2003
Country	:	US
Telephone Number	:	615-747-6035
Fax Number	:

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

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “ MS. GRACEY SANDERSON ” Practice Location

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