Healthcare Provider Details

I. General information

NPI: 1679465991
Provider Name (Legal Business Name): MARIAH ROMANO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5109 VETERANS PKWY
MURFREESBORO TN
37128-4375
US

IV. Provider business mailing address

PO BOX 306556
NASHVILLE TN
37230-6556
US

V. Phone/Fax

Practice location:
  • Phone: 615-896-6800
  • Fax: 615-895-8890
Mailing address:
  • Phone: 615-329-2294
  • Fax: 615-695-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7157
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: