MEDICARE: OLIVIA REID ABERNATHY 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
1	163WM0705X	Medical-Surgical Registered Nurse	193223	TN
2	363LF0000X	Family Nurse Practitioner	28724	TN

General Provider Information

NPI Number	:	1649866906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA REID ABERNATHY FNP-C

Provider Business Mailing Address
First Line	:	706 FLINTLOCK CT
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-3615
Country	:	US
Telephone Number	:	704-530-3922
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 STEAM PLANT RD STE 235
Second Line	:
City	:	GALLATIN
State	:	TN
Zip	:	37066-3032
Country	:	US
Telephone Number	:	615-206-3079
Fax Number	:	615-206-3093

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

Provider Enumeration Date	:	12/21/2020
Last Update Date	:	12/21/2020

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