Healthcare Provider Details

I. General information

NPI: 1306700281
Provider Name (Legal Business Name): NATHALIE NORDSTROM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 N MOUNT JULIET RD STE 201
MT JULIET TN
37122-4498
US

IV. Provider business mailing address

2325 NASHVILLE PIKE APT 635
GALLATIN TN
37066-6022
US

V. Phone/Fax

Practice location:
  • Phone: 615-438-3615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: