Provider Demographics
NPI:1528303674
Name:ABSOLUTE FAMILY HEALTH
Entity type:Organization
Organization Name:ABSOLUTE FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:RENDON
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:901-791-4101
Mailing Address - Street 1:2840 SUMMER OAKS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3854
Mailing Address - Country:US
Mailing Address - Phone:901-791-4101
Mailing Address - Fax:901-791-4177
Practice Address - Street 1:2840 SUMMER OAKS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3854
Practice Address - Country:US
Practice Address - Phone:901-791-4101
Practice Address - Fax:901-791-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14921363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10350I3799OtherMEDICARE PTAN
TN1520075Medicaid