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General NPI Number Information
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NPI Number | 1386159333
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Entity Type | Organization
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Legal Business Name | PROVIDER GUIDANCE LLC
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 12/12/2017
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Provider Practice Location Address
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Address Line | 5646 AMALIE DR APT F104
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City | NASHVILLE
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State | TN
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Zip | 37211-5941
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Country | US
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Telephone | 615-832-8428
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Fax | 615-832-8428
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Provider Business Mailing Address
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Address Line | 5646 AMALIE DR APT F104
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City | NASHVILLE
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State | TN
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Zip | 37211-5941
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Country | US
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Telephone | 615-832-8428
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Fax | 615-832-8428
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. PAMELA LYNETTE CANE
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Credential | MA
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Telephone | 615-796-7821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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