Individual
MR. WAYNE RUSSELL BABCOCK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
1 MEDICAL CENTER BLVD, COOKEVILLE, TN 38501-4294
(931) 783-2770
(931) 525-1176
Mailing address
127 N OAK AVE, SUITE D, COOKEVILLE, TN 38501-2435
(931) 783-5857
(931) 526-6760
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APN17208
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6053298
BCBS
TN
05
—
7100260170
—
KY
05
—
Q000589
—
TN
Enumeration date
12/14/2012
Last updated
05/15/2017
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