Healthcare Provider Details

I. General information

NPI: 1306349899
Provider Name (Legal Business Name): VILLANUEVA TOPAZE SPIVEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 ANTHONY RD
MACON GA
31204-5823
US

IV. Provider business mailing address

73 WHITE BRIDGE RD STE 103-243
NASHVILLE TN
37205-1444
US

V. Phone/Fax

Practice location:
  • Phone: 615-673-6737
  • Fax: 800-474-4039
Mailing address:
  • Phone: 615-673-6737
  • Fax: 800-474-4039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN201148
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: