MEDICARE: JENNIFER CARMICHAEL

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	363LF0000X	Family Nurse Practitioner	28943	TN

General Provider Information

NPI Number	:	1952991788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CARMICHAEL

Provider Business Mailing Address
First Line	:	5836 LILLIAN BEND DR
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-4370
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8336 MACON RD
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-8554
Country	:	US
Telephone Number	:	901-682-3035
Fax Number	:

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

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	03/08/2023

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