Individual
RICHARD L PEMBRIDGE JR.
Active
Individual
RICHARD L PEMBRIDGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
APN0000010596
TN
363L00000X
Nurse Practitioner
10596
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
10596
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515000
—
TN
01
—
4313518
BLUE CROSS-BLUE SHIELD
TN
05
—
7100090190
—
KY
01
—
P01004443
RR MEDICARE
TN
Enumeration date
06/23/2006
Last updated
10/20/2014
Update your record
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