MEDICARE: SUSAN NEPHEW

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	225X00000X	Occupational Therapist	3851	TN

General Provider Information

NPI Number	:	1588988596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN NEPHEW

Provider Business Mailing Address
First Line	:	1028 BELCOR DR
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-8644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 TOWN CENTER PKWY
Second Line	:	SUITE 204
City	:	SPRING HILL
State	:	TN
Zip	:	37174-4407
Country	:	US
Telephone Number	:	931-487-9787
Fax Number	:	931-487-9788

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

Provider Enumeration Date	:	03/19/2010
Last Update Date	:	11/14/2011

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Directions to “ SUSAN NEPHEW ” Practice Location

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