Provider Demographics
NPI:1114237278
Name:MEDICINE IN MOTION OF MIDDLE TENNESSEE
Entity Type:Organization
Organization Name:MEDICINE IN MOTION OF MIDDLE TENNESSEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLERBY-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:615-887-8835
Mailing Address - Street 1:7385 SUGARLOAF DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4617
Mailing Address - Country:US
Mailing Address - Phone:615-887-8835
Mailing Address - Fax:615-599-6112
Practice Address - Street 1:7385 SUGARLOAF DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4617
Practice Address - Country:US
Practice Address - Phone:615-887-8835
Practice Address - Fax:615-599-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty