Organization
THIRD CIRCLE MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CENCHREA LANIER MSN-ANP-BC (NP)
(615) 714-8715
Entity
Organization
Contact information
Practice address
6011 TROTWOOD AVE STE 400, COLUMBIA, TN 38401-7022
(615) 505-8014
(931) 505-8013
Mailing address
6011 TROTWOOD AVE STE 400, COLUMBIA, TN 38401-7022
(931) 505-8014
(931) 505-8013
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114731
STATE OF TENNESSEE
TN
01
—
16491
STATE OF TENNESSEE BOARD OF NURSING
TN
01
—
1962775999
NPPES
TN
Enumeration date
10/23/2021
Last updated
05/19/2022
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