Healthcare Provider Details

I. General information

NPI: 1740777580
Provider Name (Legal Business Name): TARA ANN SAXENA MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 21ST AVE S
NASHVILLE TN
37232-2730
US

IV. Provider business mailing address

1161 21ST AVE S
NASHVILLE TN
37232-2730
US

V. Phone/Fax

Practice location:
  • Phone: 615-875-9968
  • Fax: 615-322-0689
Mailing address:
  • Phone: 615-875-9968
  • Fax: 615-322-0689

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: