Healthcare Provider Details

I. General information

NPI: 1598458564
Provider Name (Legal Business Name): JEFFANIE WU GAYOSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEFFANIE WU

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 21ST AVE S
NASHVILLE TN
37232-0014
US

IV. Provider business mailing address

164 STONECREST DR
NASHVILLE TN
37209-5236
US

V. Phone/Fax

Practice location:
  • Phone: 630-770-9802
  • Fax:
Mailing address:
  • Phone: 630-770-9802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: