Healthcare Provider Details

I. General information

NPI: 1255245700
Provider Name (Legal Business Name): NEBYOU F MEKURIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 BENCH MARK DR
ANTIOCH TN
37013-1128
US

IV. Provider business mailing address

4449 BENCH MARK DR
ANTIOCH TN
37013-1128
US

V. Phone/Fax

Practice location:
  • Phone: 615-877-4595
  • Fax:
Mailing address:
  • Phone: 615-877-4595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number8257
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: