Individual
AMANDA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 W CALDWELL ST STE 200, MT JULIET, TN 37122-3179
(615) 941-8501
(615) 941-8102
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 239-2018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
160038
TN
363L00000X
Nurse Practitioner
Primary
18969
TN
363LF0000X
Family Nurse Practitioner
18969
TN
Other
Enumeration date
07/30/2014
Last updated
11/16/2023
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