MEDICARE: MS. ANNIE BABY NINAN FNP-BC

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	16136	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295001824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNIE BABY NINAN FNP-BC

Provider Business Mailing Address
First Line	:	2275 MURFREESBORO PIKE
Second Line	:	STE 110
City	:	NASHVILLE
State	:	TN
Zip	:	37217-3341
Country	:	US
Telephone Number	:	615-833-6898
Fax Number	:	615-833-6895

Provider Business Practice Location Address
First Line	:	2275 MURFREESBORO PIKE
Second Line	:	STE 110
City	:	NASHVILLE
State	:	TN
Zip	:	37217-3341
Country	:	US
Telephone Number	:	615-833-6898
Fax Number	:	615-833-6895

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

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	04/26/2013

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