Provider Demographics
NPI:1528033016
Name:RAWLS, CONNIE ELAINE (FNPC)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:ELAINE
Last Name:RAWLS
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 STONEGATE PL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4388
Mailing Address - Country:US
Mailing Address - Phone:615-376-7820
Mailing Address - Fax:
Practice Address - Street 1:2000 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4692
Practice Address - Country:US
Practice Address - Phone:615-558-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5654363L00000X, 363LF0000X, 363LP2300X
FLTPAN1603363LF0000X
CO0102276363LF0000X
VA0024190111363LF0000X
NV880672363LF0000X
UT14077808-4405363LF0000X
SC29427363LF0000X
MO2024034170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily