Individual
MR. MADISON D PETTIGREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APN, PMHNP-BC
Contact information
Practice address
8130 COUNTRY VILLAGE DR STE 103, CORDOVA, TN 38016-2087
(901) 308-2915
(901) 308-2924
Mailing address
8130 COUNTRY VILLAGE DR STE 102, CORDOVA, TN 38016-2087
(901) 308-2915
(901) 308-2924
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
171949
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28484
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
904213
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1I5219
MEDICARE
MS
05
—
T24221A
—
TN
Enumeration date
08/04/2010
Last updated
08/01/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us