MEDICARE: LACRETIA AIRRELLE HENRY RN

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	224642	TN

General Provider Information

NPI Number	:	1699628032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACRETIA AIRRELLE HENRY RN

Provider Business Mailing Address
First Line	:	1137 WOODBURY FALLS CT
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-1414
Country	:	US
Telephone Number	:	629-253-2300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 HARDING PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2005
Country	:	US
Telephone Number	:	629-253-2300
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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