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NPI Code Detail

MEDICARE: MS. ELANE RUTH CHILDRESS RN

MEDICARE: MS. ELANE RUTH CHILDRESS 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
1163WC1500XCommunity Health Registered NurseRN0000034874TN

General Provider Information

NPI Number : 1962547810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELANE RUTH CHILDRESS RN
Provider Business Mailing Address
First Line : 6501 TELECOM DR
Second Line :
City : MILAN
State : TN
Zip : 38358-3448
Country : US
Telephone Number : 731-686-9240
Fax Number : 731-686-0962
Provider Business Practice Location Address
First Line : 6501 TELECOM DR
Second Line :
City : MILAN
State : TN
Zip : 38358-3448
Country : US
Telephone Number : 731-686-9240
Fax Number : 731-686-0962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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Directions to “ MS. ELANE RUTH CHILDRESS RN” Practice Location

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