MEDICARE: MRS. CAROL H SCROGGINS FNP

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	A810407	MS
2	363L00000X	Nurse Practitioner	14092	TN

General Provider Information

NPI Number	:	1962646638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL H SCROGGINS FNP

Provider Business Mailing Address
First Line	:	8066 WALNUT RUN RD STE 100
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-8842
Country	:	US
Telephone Number	:	901-881-2260
Fax Number	:	901-881-0680

Provider Business Practice Location Address
First Line	:	8066 WALNUT RUN RD STE 100
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-8842
Country	:	US
Telephone Number	:	901-881-2260
Fax Number	:	901-881-0680

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

Provider Enumeration Date	:	04/26/2009
Last Update Date	:	08/01/2025

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