Healthcare Provider Details

I. General information

NPI: 1912766783
Provider Name (Legal Business Name): ALLISON KERMANSHAHI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 LEBANON PIKE
HERMITAGE TN
37076-2013
US

IV. Provider business mailing address

3227 LINCOYA CREEK DR
NASHVILLE TN
37214-2781
US

V. Phone/Fax

Practice location:
  • Phone: 615-367-1444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number35886
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: