Provider Demographics
NPI:1871978486
Name:WETHERELL, MEREDITH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:WETHERELL
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:MEREDITH
Other - Middle Name:JUNE
Other - Last Name:WETHERELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6041 RURAL PLAINS CIR STE 110
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1955
Mailing Address - Country:US
Mailing Address - Phone:629-999-1591
Mailing Address - Fax:
Practice Address - Street 1:6041 RURAL PLAINS CIR STE 110114
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1954
Practice Address - Country:US
Practice Address - Phone:629-999-1591
Practice Address - Fax:615-685-6245
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28699363LF0000X
NY014421225700000X
NYF339802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist