MEDICARE: DR. KARL NICHOLS JANNASCH PH.D.

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	103TC0700X	Clinical Psychologist	P0000001550	TN

General Provider Information

NPI Number	:	1467411520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL NICHOLS JANNASCH PH.D.

Provider Business Mailing Address
First Line	:	110 30TH AVE S
Second Line	:	SUITE 200
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2511
Country	:	US
Telephone Number	:	615-321-2597
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 30TH AVE S
Second Line	:	SUITE 200
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2511
Country	:	US
Telephone Number	:	615-321-2597
Fax Number	:

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

Provider Enumeration Date	:	03/18/2006
Last Update Date	:	07/08/2007

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