Healthcare Provider Details

I. General information

NPI: 1528584216
Provider Name (Legal Business Name): CHANILLE R WITHAM RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHANILLE R DUNN RN

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-2214
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number27449
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number219447-30
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number148942-32
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: