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NPI Code Detail

MEDICARE: PAIGE PERNELL FNP-BC

MEDICARE: PAIGE PERNELL FNP-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
1363LF0000XFamily Nurse Practitioner20891TN

General Provider Information

NPI Number : 1598123291
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE PERNELL FNP-BC
Provider Business Mailing Address
First Line : 42 DOOLEY ST
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-4055
Country : US
Telephone Number : 931-707-7117
Fax Number :
Provider Business Practice Location Address
First Line : 42 DOOLEY ST
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-4055
Country : US
Telephone Number : 931-707-7117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2016
Last Update Date : 02/09/2016

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Directions to “ PAIGE PERNELL FNP-BC” Practice Location

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