Provider Demographics
NPI:1134109283
Name:NUTT, STEPHEN D (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:NUTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 N TENNESSEE BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2636
Mailing Address - Country:US
Mailing Address - Phone:615-893-5679
Mailing Address - Fax:615-890-8563
Practice Address - Street 1:1114 N TENNESSEE BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2636
Practice Address - Country:US
Practice Address - Phone:615-893-5679
Practice Address - Fax:615-890-8563
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730889Medicare ID - Type UnspecifiedGROUP NUMBER
TNT74673Medicare UPIN
TN3674423Medicare ID - Type UnspecifiedPROVIDER ID