Healthcare Provider Details

I. General information

NPI: 1891998431
Provider Name (Legal Business Name): ANNE ELIZABETH FONTAINE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 ORIEL AVE
NASHVILLE TN
37210-4910
US

IV. Provider business mailing address

605 WATSONWOOD DR
NASHVILLE TN
37211-5322
US

V. Phone/Fax

Practice location:
  • Phone: 615-862-7940
  • Fax: 615-880-2194
Mailing address:
  • Phone: 615-331-5150
  • Fax: 615-880-2194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN49133
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: