Healthcare Provider Details

I. General information

NPI: 1457169039
Provider Name (Legal Business Name): WALA'A BAHOUR CPNP-PC, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 WALLACE RD STE 202
NASHVILLE TN
37211-4834
US

IV. Provider business mailing address

393 WALLACE RD STE 202
NASHVILLE TN
37211-4834
US

V. Phone/Fax

Practice location:
  • Phone: 615-709-2057
  • Fax: 855-888-1434
Mailing address:
  • Phone: 615-709-2057
  • Fax: 855-888-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number37598
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: