Healthcare Provider Details

I. General information

NPI: 1457753162
Provider Name (Legal Business Name): SUNITA G TRYAMBAKE AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 WHITE BRIDGE RD STE 103-243
NASHVILLE TN
37205-1444
US

IV. Provider business mailing address

2835 HIGHWAY 231 N
SHELBYVILLE TN
37160-7327
US

V. Phone/Fax

Practice location:
  • Phone: 615-673-6737
  • Fax: 800-474-4039
Mailing address:
  • Phone: 931-685-5433
  • Fax: 931-685-8266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20760
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: