Provider Demographics
NPI:1386741361
Name:STORY, JANIS LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:LYNN
Last Name:STORY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JANIS
Other - Middle Name:STEPHENS
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 WALNUT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:TN
Mailing Address - Zip Code:38316-9788
Mailing Address - Country:US
Mailing Address - Phone:615-441-6000
Mailing Address - Fax:731-729-5617
Practice Address - Street 1:1904 HIGHWAY 46 S STE 3
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-7745
Practice Address - Country:US
Practice Address - Phone:615-441-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 5516363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4096538Medicaid
TN4096538Medicaid
3305135Medicare PIN