Healthcare Provider Details

I. General information

NPI: 1902631484
Provider Name (Legal Business Name): HANNAH WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 W END AVE STE 101F
NASHVILLE TN
37203-6877
US

IV. Provider business mailing address

3415 W END AVE STE 101F
NASHVILLE TN
37203-6877
US

V. Phone/Fax

Practice location:
  • Phone: 615-891-4037
  • Fax: 615-457-1796
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number15610
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: