Healthcare Provider Details

I. General information

NPI: 1497126403
Provider Name (Legal Business Name): LAUREN ALEXANDRA BRUNHOEBER AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 21ST AVE S MCN 1214
NASHVILLE TN
37232-0011
US

IV. Provider business mailing address

4401 GEORGIA AVE UNIT A
NASHVILLE TN
37209-2317
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number20555
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: