Individual
MRS. CHARMAINE JACKSON KRUPKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, FNP-BC, IBCLC
Contact information
Practice address
4928 EDMONDSON PIKE STE 205, NASHVILLE, TN 37211-4791
(615) 222-1400
(615) 222-1410
Mailing address
1003 MANSFIELD AVE, NASHVILLE, TN 37206-3515
(615) 394-2680
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
16156
TN
367A00000X
Advanced Practice Midwife
16156
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q034583
—
TN
01
—
T00242A
MEDICARE
TN
Enumeration date
10/12/2011
Last updated
02/13/2025
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