Provider Demographics
NPI:1750687422
Name:ELDRED, STORMIEE DANIELLE (FNP- BC)
Entity Type:Individual
Prefix:MRS
First Name:STORMIEE
Middle Name:DANIELLE
Last Name:ELDRED
Suffix:
Gender:F
Credentials:FNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-4004
Mailing Address - Country:US
Mailing Address - Phone:615-735-3450
Mailing Address - Fax:615-735-3560
Practice Address - Street 1:133 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-4004
Practice Address - Country:US
Practice Address - Phone:615-735-3450
Practice Address - Fax:615-735-3560
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN15513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily