Basic Information
| Provider Information | |||||||||
| NPI: | 1881134930 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NELMS | ||||||||
| FirstName: | MACY | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1607 WESTGATE CIR STE 200 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370278077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153768195 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1607 WESTGATE CIR STE 200 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370278077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153768195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2017 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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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 | APN0000022348 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.