Provider Demographics
NPI:1356055768
Name:HARWELL, SAM ROMINE IV (FNP-C)
Entity type:Individual
Prefix:
First Name:SAM
Middle Name:ROMINE
Last Name:HARWELL
Suffix:IV
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7475 COCKRILL BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7475 COCKRILL BEND BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1048
Practice Address - Country:US
Practice Address - Phone:615-350-3584
Practice Address - Fax:615-350-6735
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN32930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily