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NPI Code Detail

MEDICARE: MS. PATRICIA MAE FAJARDO FNP-C

MEDICARE: MS. PATRICIA MAE FAJARDO FNP-C
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 Practitioner24703TN

General Provider Information

NPI Number : 1609346675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA MAE FAJARDO FNP-C
Provider Business Mailing Address
First Line : 3024 BUSINESS PARK CIR
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-3132
Country : US
Telephone Number : 615-239-2018
Fax Number : 615-851-2018
Provider Business Practice Location Address
First Line : 107 GLEN OAK BLVD STE 201B
Second Line :
City : HENDERSONVILLE
State : TN
Zip : 37075-3000
Country : US
Telephone Number : 615-499-4545
Fax Number : 615-499-4546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2018
Last Update Date : 12/06/2022

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