Healthcare Provider Details

I. General information

NPI: 1609810274
Provider Name (Legal Business Name): DEBRA LEIGH HOLP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 DICKERSON PIKE
NASHVILLE TN
37207-2539
US

IV. Provider business mailing address

2020 21ST AVE S SUITE 201
NASHVILLE TN
37212-4354
US

V. Phone/Fax

Practice location:
  • Phone: 615-769-4401
  • Fax: 615-769-4730
Mailing address:
  • Phone: 615-269-0652
  • Fax: 615-269-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number19278
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: