Healthcare Provider Details

I. General information

NPI: 1073793089
Provider Name (Legal Business Name): ABEL OKUMA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 DONELSON PIKE SUITE 101
NASHVILLE TN
37214-3561
US

IV. Provider business mailing address

457 DONELSON PIKE
NASHVILLE TN
37214-3561
US

V. Phone/Fax

Practice location:
  • Phone: 615-884-0215
  • Fax:
Mailing address:
  • Phone: 615-884-0215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8096
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: