MEDICARE: LAVONIA BARROW 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	163W00000X	Registered Nurse	186471	TN
2	163W00000X	Registered Nurse	875368	TX
3	363L00000X	Nurse Practitioner	27640	TN
4	363L00000X	Nurse Practitioner	AP130091	TX
5	363L00000X	Nurse Practitioner	GAA-NP002740	GA

General Provider Information

NPI Number	:	1679947618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAVONIA BARROW FNP-C

Provider Business Mailing Address
First Line	:	953 BARBARA LYNN DR
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-1403
Country	:	US
Telephone Number	:	469-128-0053
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 BURTON HILLS BLVD STE 500
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6176
Country	:	US
Telephone Number	:	615-787-2050
Fax Number	:

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

Provider Enumeration Date	:	11/13/2015
Last Update Date	:	02/27/2025

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