Healthcare Provider Details

I. General information

NPI: 1699986943
Provider Name (Legal Business Name): LAVANYA LATHA NAGINENI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/16/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 DICKERSON PIKE STE 580
NASHVILLE TN
37207-2526
US

IV. Provider business mailing address

3443 SKYLINE MEDICAL CENTER, SUITE 580
NASHVILLE TN
37207-0000
US

V. Phone/Fax

Practice location:
  • Phone: 615-860-1040
  • Fax:
Mailing address:
  • Phone: 615-860-1040
  • Fax: 615-860-1242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number68225
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA93317
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberM9524
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: