Healthcare Provider Details

I. General information

NPI: 1477147403
Provider Name (Legal Business Name): ALEXANDER CAMPANERIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2021
Last Update Date: 03/24/2024
Certification Date: 03/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PATTERSON ST
NASHVILLE TN
37203-1538
US

IV. Provider business mailing address

555 HARTSVILLE PIKE
GALLATIN TN
37066-2400
US

V. Phone/Fax

Practice location:
  • Phone: 615-342-1000
  • Fax:
Mailing address:
  • Phone: 615-328-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number244970
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number28087
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: