Basic Information
| Provider Information | |||||||||
| NPI: | 1699225367 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JUDKINS | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | BARRERA | ||||||||
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| Credential: | FNP-C | ||||||||
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| OtherLastName: | BARRERA | ||||||||
| OtherFirstName: | LAUREN | ||||||||
| OtherMiddleName: | ASHLEY | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5141 VIRGINIA WAY | ||||||||
| Address2: | STE 390 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370279505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159337073 | ||||||||
| FaxNumber: | 6159881635 | ||||||||
| Practice Location | |||||||||
| Address1: | 2377 FAIRVIEW BLVD | ||||||||
| Address2: | |||||||||
| City: | FAIRVIEW | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370626003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157990101 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2016 | ||||||||
| LastUpdateDate: | 11/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 21893 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.