MEDICARE: PAT LANIER ST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZS0410X	Surgical Technologist

General Provider Information

NPI Number	:	1366608515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAT LANIER ST

Provider Business Mailing Address
First Line	:	6202 PENNSYLVANIA AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-1342
Country	:	US
Telephone Number	:	615-298-1877
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 CHURCH ST
Second Line	:	PLAZA 1, LOWER LEVEL
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2000
Country	:	US
Telephone Number	:	615-515-4018
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	08/06/2008

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Directions to “ PAT LANIER ST” Practice Location

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