Healthcare Provider Details

I. General information

NPI: 1326224015
Provider Name (Legal Business Name): VANDERBILT CHILDRENS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 CHILDRENS WAY STE 3115
NASHVILLE TN
37232-0005
US

IV. Provider business mailing address

805 PARK DR
GOODLETTSVILLE TN
37072-3147
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-0023
  • Fax:
Mailing address:
  • Phone: 615-448-6034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DEANA CHRISTINA VANDIVIER
Title or Position: NURSE ANESTHETIST
Credential: CRNA
Phone: 615-936-0027