Healthcare Provider Details

I. General information

NPI: 1972431005
Provider Name (Legal Business Name): NOOR TAHER ANAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NOOR IBRAHIM

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 21ST AVE S MEDICAL CENTER NORTH, SUITE CCC-4303
NASHVILLE TN
37232-0011
US

IV. Provider business mailing address

1161 21ST AVE S MEDICAL CENTER NORTH, SUITE CCC-4303
NASHVILLE TN
37232-0011
US

V. Phone/Fax

Practice location:
  • Phone: 615-343-6642
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1972431005
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: