Provider Demographics
NPI:1538497888
Name:RIEDEL, JULIE A (FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:RIEDEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 MURFREESBORO RD
Mailing Address - Street 2:SUITE 319
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1306
Mailing Address - Country:US
Mailing Address - Phone:615-790-0567
Mailing Address - Fax:615-595-8030
Practice Address - Street 1:1113 MURFREESBORO RD
Practice Address - Street 2:SUITE 319
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1306
Practice Address - Country:US
Practice Address - Phone:615-790-0567
Practice Address - Fax:615-595-8030
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14604363LF0000X
TN59038163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517612Medicaid
TN4251779OtherBCBST
TN1517612Medicaid