Healthcare Provider Details

I. General information

NPI: 1104361906
Provider Name (Legal Business Name): NATHAN J JOHNSON FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 HARDING PIKE STE 327
NASHVILLE TN
37205-2118
US

IV. Provider business mailing address

2725 STANDING OAK DR
THOMPSONS STATION TN
37179-9756
US

V. Phone/Fax

Practice location:
  • Phone: 615-416-8010
  • Fax: 615-915-3436
Mailing address:
  • Phone: 615-210-8739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000021805
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: