MEDICARE: DESIREE BELLE UY DY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN103734	TN

General Provider Information

NPI Number	:	1215902564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE BELLE UY DY FNP

Provider Business Mailing Address
First Line	:	308 SEMINOLE CT
Second Line	:
City	:	GOODLETTSVILLE
State	:	TN
Zip	:	37072-3339
Country	:	US
Telephone Number	:	615-733-0211
Fax Number	:	615-733-0212

Provider Business Practice Location Address
First Line	:	1421 ELM HILL PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37210
Country	:	US
Telephone Number	:	615-733-0211
Fax Number	:	615-733-0212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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