Healthcare Provider Details

I. General information

NPI: 1578331344
Provider Name (Legal Business Name): MICHAEL A KUOL APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 14TH AVE N
NASHVILLE TN
37208-3050
US

IV. Provider business mailing address

1035 14TH AVE N
NASHVILLE TN
37208-3050
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-9400
  • Fax:
Mailing address:
  • Phone: 615-340-1270
  • Fax: 615-321-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN0000035014
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: