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General NPI Number Information
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NPI Number | 1568377935
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Entity Type | Individual
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Provider Name | ALLYSON SAN ROMAN OTD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 1460 MCGAVOCK PIKE
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City | NASHVILLE
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State | TN
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Zip | 37216-3225
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Country | US
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Telephone | 615-652-2344
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Fax |
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Provider Business Mailing Address
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Address Line | 559 WATSONWOOD DR
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City | NASHVILLE
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State | TN
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Zip | 37211-5320
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Country | US
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Telephone | 714-305-1678
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | TN
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