MEDICARE: JAMES ELDRIDGE NP

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	19423	TN

General Provider Information

NPI Number	:	1477951036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ELDRIDGE NP

Provider Business Mailing Address
First Line	:	300 SEVEN SPRINGS WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-6069
Country	:	US
Telephone Number	:	931-967-0543
Fax Number	:	931-967-1888

Provider Business Practice Location Address
First Line	:	144 JACK FARRAR LN
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2398
Country	:	US
Telephone Number	:	931-968-3145
Fax Number	:

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

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	05/09/2024

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