Healthcare Provider Details

I. General information

NPI: 1548841778
Provider Name (Legal Business Name): ATHENA CATHERINE RAPACZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ATHENA CATHERINE REESE PA-C

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 HARDING PIKE STE 327
NASHVILLE TN
37205-2118
US

IV. Provider business mailing address

805 CHEROKEE AVE UNIT 6
NASHVILLE TN
37207-5285
US

V. Phone/Fax

Practice location:
  • Phone: 615-416-8010
  • Fax:
Mailing address:
  • Phone: 256-859-8590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4512
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: