Healthcare Provider Details

I. General information

NPI: 1932144367
Provider Name (Legal Business Name): LAQUITA T CHEATHAM MSN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7021 WESTBELT DR
NASHVILLE TN
37209-1023
US

IV. Provider business mailing address

7021 WESTBELT DR
NASHVILLE TN
37209-1023
US

V. Phone/Fax

Practice location:
  • Phone: 615-350-4805
  • Fax: 615-350-4861
Mailing address:
  • Phone: 615-350-4805
  • Fax: 615-350-4861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN6269
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN77469
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: