Provider Demographics
NPI:1881845857
Name:AUGUSTIN, MICHELE LEE (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEE
Last Name:AUGUSTIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37065-0190
Mailing Address - Country:US
Mailing Address - Phone:615-794-5009
Mailing Address - Fax:615-791-9702
Practice Address - Street 1:1345 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3703
Practice Address - Country:US
Practice Address - Phone:615-794-5009
Practice Address - Fax:615-791-9702
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13620363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I501116Medicare PIN