Healthcare Provider Details

I. General information

NPI: 1003211145
Provider Name (Legal Business Name): MONROE CARELL JR. CHILDREN'S HOSPITAL AT VANDERBILT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2014
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 CHILDRENS WAY PRESTON RESEARCH BLDG 395
NASHVILLE TN
37232-0005
US

IV. Provider business mailing address

2200 CHILDRENS WAY PRESTON RESEARCH BLDG 395
NASHVILLE TN
37232-0005
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-1762
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number19316
License Number StateTN

VIII. Authorized Official

Name: MARILYN A DUBREE
Title or Position: EXECUTIVE CHIEF NURSING OFFICER
Credential:
Phone: 615-322-0735