Healthcare Provider Details

I. General information

NPI: 1366572505
Provider Name (Legal Business Name): MEGHANN PINE MCMANUS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 23RD AVE N STE 450
NASHVILLE TN
37203-1661
US

IV. Provider business mailing address

330 23RD AVE N STE 450
NASHVILLE TN
37203-1661
US

V. Phone/Fax

Practice location:
  • Phone: 856-237-7985
  • Fax:
Mailing address:
  • Phone: 615-342-7339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number7932540-1204
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberDO0000002104
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: