Healthcare Provider Details

I. General information

NPI: 1053758516
Provider Name (Legal Business Name): NICOLE KRISTEN PERRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 23RD AVE N STE 550
NASHVILLE TN
37203-1706
US

IV. Provider business mailing address

330 23RD AVE N STE 550
NASHVILLE TN
37203-1706
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-8549
  • Fax:
Mailing address:
  • Phone: 615-321-8549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number59828
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number284114
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number284114
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: