Provider Demographics
NPI:1407943533
Name:MICHAEL, PATRICIA M (APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BENTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2303
Mailing Address - Country:US
Mailing Address - Phone:615-932-7629
Mailing Address - Fax:615-385-1842
Practice Address - Street 1:2637 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3505
Practice Address - Country:US
Practice Address - Phone:615-250-1475
Practice Address - Fax:615-964-6951
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN06497363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1508321Medicaid
TN1508321Medicaid
TN39022131Medicare PIN