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General NPI Number Information
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NPI Number | 1871417683
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Entity Type | Organization
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Legal Business Name | EVERGREEN HEALTHCARE TENNESSEE LLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 445 BENTON AVE UNIT 311
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City | NASHVILLE
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State | TN
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Zip | 37204-2684
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Country | US
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Telephone | 315-415-3546
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Fax |
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Provider Business Mailing Address
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Address Line | 445 BENTON AVE UNIT 311
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City | NASHVILLE
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State | TN
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Zip | 37204-2684
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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 | CEO
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Name | FREMLIN DEKYI JR.
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Credential | MD
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Telephone | 917-428-8463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number |
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License Number State |
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