Healthcare Provider Details

I. General information

NPI: 1457544991
Provider Name (Legal Business Name): JENNIFER ESBENSHADE MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2007
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 SEABOARD LN SUITE 201
BRENTWOOD TN
37027-3031
US

IV. Provider business mailing address

95 SEABOARD LN SUITE 201
BRENTWOOD TN
37027-3031
US

V. Phone/Fax

Practice location:
  • Phone: 615-261-1210
  • Fax: 615-261-1222
Mailing address:
  • Phone: 615-261-1210
  • Fax: 615-261-1222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD43970
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: