Provider Demographics
NPI:1972896041
Name:ATKINS, GLENDA TAYLOR (FNP)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:TAYLOR
Last Name:ATKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GLENDA
Other - Middle Name:MARIE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1021 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058-3302
Mailing Address - Country:US
Mailing Address - Phone:931-232-5329
Mailing Address - Fax:931-232-7247
Practice Address - Street 1:1021 SPRING ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3302
Practice Address - Country:US
Practice Address - Phone:931-232-5329
Practice Address - Fax:931-232-7247
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015772363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily