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General NPI Number Information
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NPI Number | 1386962678
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Entity Type | Organization
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Legal Business Name | NASHVILLE PAIN CENTER - CLARKSVILLE
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 05/11/2010
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Provider Practice Location Address
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Address Line | 781 WEATHERLY DR UNIT D
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City | CLARKSVILLE
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State | TN
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Zip | 37043-8953
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Country | US
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Telephone | 931-647-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 781 WEATHERLY DR UNIT D
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City | CLARKSVILLE
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State | TN
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Zip | 37043-8953
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Country | US
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Telephone | 931-647-3050
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Fax |
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Authorized Official
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Title or Position | NP
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Name | KATHARINE C VACHON
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Credential | NP, MSN
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Telephone | 931-647-3050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11796
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License Number State | TN
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