Healthcare Provider Details

I. General information

NPI: 1518079128
Provider Name (Legal Business Name): CATHERINE E. REISENBERG APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BENTON AVE
NASHVILLE TN
37204
US

IV. Provider business mailing address

222 GODCHAUX HALL 46121ST AVE SO
NASHVILLE TN
37240-0001
US

V. Phone/Fax

Practice location:
  • Phone: 615-292-9770
  • Fax: 616-292-9706
Mailing address:
  • Phone: 615-343-3250
  • Fax: 615-343-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN6093
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: