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NPI Code Detail

MEDICARE: JANE CARLISLE

MEDICARE: JANE CARLISLE
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
1208100000XPhysical Medicine & Rehabilitation PhysicianPT0004654TN

General Provider Information

NPI Number : 1609132836
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE CARLISLE
Provider Business Mailing Address
First Line : 2601 BRANSFORD AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37204-2811
Country : US
Telephone Number : 615-259-8698
Fax Number :
Provider Business Practice Location Address
First Line : 2601 BRANSFORD AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37204-2811
Country : US
Telephone Number : 615-259-8698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2012
Last Update Date : 04/02/2012

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Directions to “ JANE CARLISLE ” Practice Location

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