Individual
LARRY M. CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-1562
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 515-1993
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APN7717
TN
363LA2200X
Adult Health Nurse Practitioner
Primary
7717
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39286401
—
TN
01
—
P00400695
RR MEDICARE
TN
Enumeration date
09/15/2006
Last updated
06/21/2023
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