Healthcare Provider Details

I. General information

NPI: 1649619354
Provider Name (Legal Business Name): AMY KORCZYNSKI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 W END AVE STE 620
NASHVILLE TN
37203-6910
US

IV. Provider business mailing address

3310 W END AVE STE 620
NASHVILLE TN
37203-6910
US

V. Phone/Fax

Practice location:
  • Phone: 615-657-4800
  • Fax: 954-337-2733
Mailing address:
  • Phone: 615-986-1256
  • Fax: 615-383-0853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number2347
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2347
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: