1326081738 NPI number — LINDSEY B CORLEW APN

Table of content: LINDSEY B CORLEW APN (NPI 1326081738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326081738 NPI number — LINDSEY B CORLEW APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORLEW
Provider First Name:
LINDSEY
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326081738
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 GREAT CIRCLE RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37228-1317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-222-1900
Provider Business Mailing Address Fax Number:
615-222-1917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5201 CHARLOTTE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37209-3320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-222-1900
Provider Business Practice Location Address Fax Number:
615-222-1917
Provider Enumeration Date:
06/14/2006

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: 363L00000X , with the licence number:  11825 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 11825 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3343991 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4141485 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4320293 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: P00778981 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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