Healthcare Provider Details

I. General information

NPI: 1275449779
Provider Name (Legal Business Name): ISABELLA CRISTINA GRAMICCIONI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 22ND AVE N
NASHVILLE TN
37203-1844
US

IV. Provider business mailing address

PO BOX 210127
NASHVILLE TN
37221-0127
US

V. Phone/Fax

Practice location:
  • Phone: 615-320-0007
  • Fax: 855-538-3132
Mailing address:
  • Phone: 615-320-0007
  • Fax: 615-234-3488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number7388
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number7388
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: