Healthcare Provider Details

I. General information

NPI: 1649367590
Provider Name (Legal Business Name): JAMES JEFFREY KERBY PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 NOLENSVILLE RD
NASHVILLE TN
37211-6813
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US

V. Phone/Fax

Practice location:
  • Phone: 615-284-1450
  • Fax: 629-208-2691
Mailing address:
  • Phone: 615-284-1450
  • Fax: 629-208-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberA434FP
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2593
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: