Healthcare Provider Details

I. General information

NPI: 1255463949
Provider Name (Legal Business Name): VANDERBILT INTEGRATED PROVIDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 CEDAR LN
TULLAHOMA TN
37388-2485
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 615-393-7056
  • Fax:
Mailing address:
  • Phone:
  • Fax: 615-322-5048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: WENDY MONACI
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-936-3944