Healthcare Provider Details

I. General information

NPI: 1679441687
Provider Name (Legal Business Name): TORI ALEXANDRA FETTERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CHURCH ST
NASHVILLE TN
37236-4400
US

IV. Provider business mailing address

2408 FIG DR
MURFREESBORO TN
37127-1013
US

V. Phone/Fax

Practice location:
  • Phone: 629-266-8277
  • Fax:
Mailing address:
  • Phone: 908-216-2068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number242335
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: