MEDICARE: GARY WAYNE DODD ANP-BC, RN

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	363LA2200X	Adult Health Nurse Practitioner	15226	TN
2	363LA2200X	Adult Health Nurse Practitioner	RN237174	GA

General Provider Information

NPI Number	:	1952604704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY WAYNE DODD ANP-BC, RN

Provider Business Mailing Address
First Line	:	333 COMMERCE ST
Second Line	:	SUITE 700
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1826
Country	:	US
Telephone Number	:	615-913-5086
Fax Number	:	888-494-2588

Provider Business Practice Location Address
First Line	:	333 COMMERCE ST
Second Line	:	SUITE 700
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1826
Country	:	US
Telephone Number	:	615-454-9850
Fax Number	:	888-972-4927

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

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	04/21/2016

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