Healthcare Provider Details

I. General information

NPI: 1629904149
Provider Name (Legal Business Name): HETAL PATEL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 29TH AVE N STE 202
NASHVILLE TN
37203-1448
US

IV. Provider business mailing address

12222 MERIT DR STE 600
DALLAS TX
75251-3294
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-4304
  • Fax:
Mailing address:
  • Phone: 972-663-8523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number248264
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: