MEDICARE: LAUREN MICHELLE GRUDE WHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	21819	TN
2	363LW0102X	Women's Health Nurse Practitioner	21819	TN

General Provider Information

NPI Number	:	1548719313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MICHELLE GRUDE WHNP-BC

Provider Business Mailing Address
First Line	:	2101 YELLOW CREEK RD
Second Line	:
City	:	DICKSON
State	:	TN
Zip	:	37055-5235
Country	:	US
Telephone Number	:	615-613-7361
Fax Number	:

Provider Business Practice Location Address
First Line	:	3443 DICKERSON PIKE STE 310
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37207-2523
Country	:	US
Telephone Number	:	615-645-3013
Fax Number	:

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

Provider Enumeration Date	:	09/22/2016
Last Update Date	:	05/01/2025

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