Audiene M Stoneham Nance, D.I.
Individual provider Active NPI Developmental Therapist · South Fulton, TN
NPI 1982829065 · NPPES record last updated May 12, 2014
Key facts
- NPI
- 1982829065
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 311 Holmes St
South Fulton, TN 38257-2139 - Phone
- (270) 472-9515
- Fax
- (270) 472-9519
- NPI assigned
- Apr 16, 2007
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
311 Holmes St
South Fulton, TN 38257-2139
Mailing address
311 Holmes St
South Fulton, TN 38257-2139
Phone (270) 472-9515
Other providers in South Fulton, TN
- Pamela Suzette Milam
- Rice Mobile OD TN LLC
- Charles Avery Rice
- Zearle Frances Robey
- Southside Drug Inc
- Kimberly A Tilghman-Burch
- Joshua Drew Whitledge
- Virgil Dale Yates
- Nathan Yoder
All providers in South Fulton, TN · Developmental Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.