Stephanie Audas

Individual provider Active NPI Licensed Practical Nurse · McMinnville, TN

NPI 1376919712 · NPPES record last updated Aug 20, 2015

Key facts

NPI
1376919712
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
69776 (TN)
Practice address
3100 Crisp Springs Rd
McMinnville, TN 37110-5238
Phone
(931) 939-5045
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
69776TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 69776 TN Yes

Addresses

Primary practice location

3100 Crisp Springs Rd
McMinnville, TN 37110-5238

Mailing address

406 N Spring St
McMinnville, TN 37110-2134

Other providers in McMinnville, TN

All providers in McMinnville, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.