Healthcare Provider Details

I. General information

NPI: 1316826738
Provider Name (Legal Business Name): MINIS MAGNIFICENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5226 MAIN ST STE D6
SPRING HILL TN
37174-4214
US

IV. Provider business mailing address

1003 CANDYTUFT CT
FRANKLIN TN
37067-8607
US

V. Phone/Fax

Practice location:
  • Phone: 615-302-8036
  • Fax:
Mailing address:
  • Phone: 615-302-8036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SOWMINI OOMMAN
Title or Position: OWNER
Credential:
Phone: 615-302-8039