Provider Demographics
NPI:1114111978
Name:HARTLINE, MEREDITH PATTON (FNP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:PATTON
Last Name:HARTLINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BURTON HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6403
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-523-0647
Practice Address - Street 1:500 RUSSELL ST STE 3
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-5411
Practice Address - Country:US
Practice Address - Phone:662-324-2244
Practice Address - Fax:662-324-2295
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX734342363LF0000X
MSR899737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2014789-01Medicaid
TX2014789-01Medicaid