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Contact Information

JUDY B BAIN, NP
1022 GREYSTONE SQ
JACKSON, TN38305-3580
 Phone: 731-300-2001
 Fax: 731-240-8095
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JUDY B BAIN · (Female)

NPI Number 1811133622
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 12/29/2008
Last updated 02/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • GA License # RN133680
  • TN License # 13649
  • TN Medicaid 1513747
  • TN Other 4258972 BLUE CROSS BLUE SHIELD TN
  • TN Other CL6903 TGBA, LLC
Hospital affiliation(s)
  • SOUTHEASTERN REGIONAL MEDICAL CENTER - (Acute Care)
    600 PARKWAY NORTH
    NEWNAN, GA 30265
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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