Provider Demographics
NPI:1235131202
Name:WEBB, AMY LYNNE (PHD, FNP- BC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNNE
Last Name:WEBB
Suffix:
Gender:F
Credentials:PHD, FNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:200 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2176
Practice Address - Country:US
Practice Address - Phone:615-441-6140
Practice Address - Fax:615-441-6190
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ019700Medicaid
TN6061225OtherBCBS TN
TNQ019700Medicaid
TNP08318Medicare UPIN