Shade F Adigun, APN

Individual provider Active NPI Critical Care Medicine Nurse Practitioner · Powell, TN

NPI 1841636628 · NPPES record last updated Sep 14, 2020

Key facts

NPI
1841636628
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine Nurse Practitioner 363LC0200X
License
17176 (TN)
Practice address
7557B Dannaher Dr Ste 225
Powell, TN 37849-3568
Phone
(865) 647-5800
Fax
(865) 647-5979
NPI assigned
May 20, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
17176TNMDCritical Care Medicine Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 17176 TN Yes

Addresses

Primary practice location

7557B Dannaher Dr Ste 225
Powell, TN 37849-3568

Mailing address

7557B Dannaher Dr Ste 225
Powell, TN 37849-3568
Phone (865) 647-5800

Other identifiers

IdentifierTypeStateIssuer
1533108MedicaidTN

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address shade.adigun.1@10667.direct.athenahealth.com

Other providers in Powell, TN

All providers in Powell, TN · Critical Care Medicine Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.