Healthcare Provider Details

I. General information

NPI: 1003823907
Provider Name (Legal Business Name): LAURA K. ANDRESON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CHURCH STREET BOX 102
NASHVILLE TN
37236-4400
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US

V. Phone/Fax

Practice location:
  • Phone: 615-284-4672
  • Fax: 615-284-5752
Mailing address:
  • Phone: 800-566-5050
  • Fax: 317-583-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number48239
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12299
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3311
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: