MEDICARE: MS. JAN MARTIN STANLEY RN

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	RN0000131675	TN

General Provider Information

NPI Number	:	1487936811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAN MARTIN STANLEY RN

Provider Business Mailing Address
First Line	:	3351 ASPEN GROVE DR
Second Line	:	SUITE 350
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2909
Country	:	US
Telephone Number	:	615-472-1795
Fax Number	:	615-472-1797

Provider Business Practice Location Address
First Line	:	3351 ASPEN GROVE DR
Second Line	:	SUITE 350
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2909
Country	:	US
Telephone Number	:	615-472-1795
Fax Number	:	615-472-1797

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

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	09/12/2011

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