Healthcare Provider Details

I. General information

NPI: 1679791685
Provider Name (Legal Business Name): NVMS WEST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BLUEGRASS COMMONS BLVD SUITE 150
HENDERSONVILLE TN
37075-2732
US

IV. Provider business mailing address

100 BLUEGRASS COMMONS BLVD SUITE 150
HENDERSONVILLE TN
37075-2732
US

V. Phone/Fax

Practice location:
  • Phone: 615-826-1500
  • Fax: 615-826-2321
Mailing address:
  • Phone: 615-826-1500
  • Fax: 615-826-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. SEAN FRANKLYN MCCRACKEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: RN
Phone: 615-826-1500