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General NPI Number Information
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NPI Number | 1619205671
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Entity Type | Organization
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Legal Business Name | ASCEND MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 2001 CHARLOTTE AVE SUITE # 205
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City | NASHVILLE
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State | TN
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Zip | 37203-2032
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Country | US
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Telephone | 615-730-5304
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Fax | 615-730-5394
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Provider Business Mailing Address
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Address Line | 2001 CHARLOTTE AVE SUITE # 205
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City | NASHVILLE
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State | TN
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Zip | 37203-2032
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Country | US
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Telephone | 615-351-3304
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Fax | 615-794-4019
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Authorized Official
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Title or Position | OWNER
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Name | MS. AMY DAVIS
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Credential |
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Telephone | 615-730-5304
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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 | 8034
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License Number State | TN
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