1558407080 NPI number — SHARON S. HENDRIX APRN, FNP-BC

Table of content: SHARON S. HENDRIX APRN, FNP-BC (NPI 1558407080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558407080 NPI number — SHARON S. HENDRIX APRN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HENDRIX
Provider First Name:
SHARON
Provider Middle Name:
S.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMALL
Provider Other First Name:
SHARON
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558407080
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 BENTON AVENUE
Provider Second Line Business Mailing Address:
3RD FLOOR STE 300
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-322-8619
Provider Business Mailing Address Fax Number:
615-385-1842

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VANDERBILT UNIVERSITY SCHOOL OF NURSING
Provider Second Line Business Practice Location Address:
461 21ST AVENUE SOUTH
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37240-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-875-5603
Provider Business Practice Location Address Fax Number:
615-936-0228
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  14135 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 3001586 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3001586 . This is a "KENTUCKY APRN REGISTRATION NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0161470-22 . This is a "ANCC BOARD CERTIFICATION" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: APN0000014156 . This is a "APRN REGISTRATION NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1045507 . This is a "KENTUCKY RN LICENSE NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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