Provider Demographics
NPI:1881139855
Name:TENNESSEE MATERNAL FETAL MEDICINE, PLC
Entity type:Organization
Organization Name:TENNESSEE MATERNAL FETAL MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-260-7993
Mailing Address - Street 1:300 20TH AVE N STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2183
Mailing Address - Country:US
Mailing Address - Phone:615-260-7993
Mailing Address - Fax:615-284-8637
Practice Address - Street 1:300 20TH AVE N STE 702
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2183
Practice Address - Country:US
Practice Address - Phone:615-260-7993
Practice Address - Fax:615-284-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000022029163WX0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-RiskGroup - Single Specialty