Healthcare Provider Details

I. General information

NPI: 1013577477
Provider Name (Legal Business Name): NAIMISHA MARNENI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 NATCHEZ PARK DR STE 103
DICKSON TN
37055-9013
US

IV. Provider business mailing address

2004 HAYES ST STE 800
NASHVILLE TN
37203-2659
US

V. Phone/Fax

Practice location:
  • Phone: 615-740-7025
  • Fax:
Mailing address:
  • Phone: 615-329-0570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number65485
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number65485
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: