Provider Demographics
NPI:1275665846
Name:BURKHEAD, CAROL G (FNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:G
Last Name:BURKHEAD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTS HILL
Mailing Address - State:TN
Mailing Address - Zip Code:38374-5007
Mailing Address - Country:US
Mailing Address - Phone:731-549-2472
Mailing Address - Fax:
Practice Address - Street 1:644 HWY 114 SOUTH
Practice Address - Street 2:SCOTTS HILL CLINIC
Practice Address - City:SCOTTS HILL
Practice Address - State:TN
Practice Address - Zip Code:38374-0099
Practice Address - Country:US
Practice Address - Phone:731-549-3191
Practice Address - Fax:731-549-3005
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily