Provider Demographics
NPI:1548030794
Name:HERNP PLLC
Entity type:Organization
Organization Name:HERNP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GRUDE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:615-613-7361
Mailing Address - Street 1:2101 YELLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-5235
Mailing Address - Country:US
Mailing Address - Phone:615-613-7361
Mailing Address - Fax:
Practice Address - Street 1:2101 YELLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-5235
Practice Address - Country:US
Practice Address - Phone:615-613-7361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health