| Organization Name: | PHOENIX MEDICAL GROUP PLLC |
| NPI Number: | 1225111339 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTINA DARWIN (OFFICE MANAGER) |
| Mailing Address: | 740 Conference Dr Suite 1 Goodlettsville |
| State: | TN US |
| Postal Code: | 370721915 |
| Phone Number: | 6158517000 |
| Fax Number: | 6158517852 |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 02/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | APN0000012693 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |