MEDICARE: HEIDI PRUDE

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	106H00000X	Marriage & Family Therapist	3014	TN

General Provider Information

NPI Number	:	1992637276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI PRUDE

Provider Business Mailing Address
First Line	:	4825 TROUSDALE DR STE 107
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37220-1352
Country	:	US
Telephone Number	:	615-200-8625
Fax Number	:

Provider Business Practice Location Address
First Line	:	4825 TROUSDALE DR STE 107
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37220-1352
Country	:	US
Telephone Number	:	615-200-8625
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ HEIDI PRUDE ” Practice Location

Language	Start Address	Practice Location

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