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General NPI Number Information
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NPI Number | 1164609319
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Entity Type | Organization
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Legal Business Name | VANDERBILT MEDICAL CENTER
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 2200 CHILDRENS WAY
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City | NASHVILLE
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State | TN
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Zip | 37232-0034
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Country | US
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Telephone | 615-936-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 CHILDRENS WAY
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City | NASHVILLE
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State | TN
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Zip | 37232-0005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CRNA
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Name | MRS. DEANA VANDIVIER
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Credential |
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Telephone | 615-936-0027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 078178
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License Number State | TN
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