MEDICARE: MR. JOHN G GARRETT APRN

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	208VP0000X	Pain Medicine Physician	APN6925	TN
2	363LA2100X	Acute Care Nurse Practitioner	APN6925	TN

General Provider Information

NPI Number	:	1770594079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN G GARRETT APRN

Provider Business Mailing Address
First Line	:	1040 N JAMES M CAMPBELL BLVD STE 108
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-2758
Country	:	US
Telephone Number	:	931-548-8657
Fax Number	:	931-548-8658

Provider Business Practice Location Address
First Line	:	1040 N JAMES M CAMPBELL BLVD STE 108
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-2758
Country	:	US
Telephone Number	:	931-548-8657
Fax Number	:	931-548-8658

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	03/07/2023

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