Basic Information
Provider Information
NPI: 1841738978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLEN
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSN, RN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 S GERMANTOWN RD
Address2:  
City: GERMANTOWN
State: TN
PostalCode: 381382205
CountryCode: US
TelephoneNumber: 9017593100
FaxNumber: 9017593196
Practice Location
Address1: 1400 S GERMANTOWN RD
Address2:  
City: GERMANTOWN
State: TN
PostalCode: 381382205
CountryCode: US
TelephoneNumber: 9017593100
FaxNumber: 9017593196
Other Information
ProviderEnumerationDate: 02/09/2017
LastUpdateDate: 02/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X193448TNN Nursing Service ProvidersRegistered Nurse 
363LF0000XF1216703TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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