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NPI Code Detail

MEDICARE: TAYLOR BROOKE MCLEAN APN

MEDICARE: TAYLOR BROOKE MCLEAN APN
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
1363L00000XNurse Practitioner19680TN
2363LA2200XAdult Health Nurse Practitioner19680TN
3363LG0600XGerontology Nurse Practitioner19680TN
4363LP2300XPrimary Care Nurse Practitioner19680TN

General Provider Information

NPI Number : 1508259508
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR BROOKE MCLEAN APN
Provider Business Mailing Address
First Line : 2075 PLEASANT PLAINS EXT RD
Second Line :
City : JACKSON
State : TN
Zip : 38305-6087
Country : US
Telephone Number : 731-984-8400
Fax Number : 731-984-8305
Provider Business Practice Location Address
First Line : 2075 PLEASANT PLAINS EXT RD
Second Line :
City : JACKSON
State : TN
Zip : 38305-6087
Country : US
Telephone Number : 731-984-8400
Fax Number : 731-984-8305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2015
Last Update Date : 03/15/2015

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