Provider Demographics
NPI:1528109618
Name:MINCHEY, T. TAYLOR (MSN)
Entity type:Individual
Prefix:
First Name:T.
Middle Name:TAYLOR
Last Name:MINCHEY
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MAPLE ROW BLVD
Mailing Address - Street 2:STE. 202
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4487
Mailing Address - Country:US
Mailing Address - Phone:615-822-9002
Mailing Address - Fax:615-827-0110
Practice Address - Street 1:139 MAPLE ROW BLVD
Practice Address - Street 2:STE. 202
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4487
Practice Address - Country:US
Practice Address - Phone:615-822-9002
Practice Address - Fax:615-827-0110
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341211Medicaid
TN3341211Medicare PIN