Healthcare Provider Details

I. General information

NPI: 1164954855
Provider Name (Legal Business Name): JORDAN NICOLE DRAWBRIDGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-9760
US

IV. Provider business mailing address

719 THOMPSON LN STE 30330
NASHVILLE TN
37204-4701
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3000
  • Fax: 615-936-3601
Mailing address:
  • Phone: 615-322-3000
  • Fax: 615-936-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61185
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberV0383
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: