Provider Demographics
NPI:1992144380
Name:NASHVILLE PEDIATRIC PROVIDERS, LLC
Entity type:Organization
Organization Name:NASHVILLE PEDIATRIC PROVIDERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFILIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:PNP
Authorized Official - Phone:615-988-2340
Mailing Address - Street 1:PO BOX 2047
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-2047
Mailing Address - Country:US
Mailing Address - Phone:615-988-2340
Mailing Address - Fax:615-988-2643
Practice Address - Street 1:590 BENZING ROAD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-988-2340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8448363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty