MEDICARE: MRS. MARY ELLEN EGGER

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	363LW0102X	Women's Health Nurse Practitioner	APN0000012695	TN

General Provider Information

NPI Number	:	1518039031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ELLEN EGGER

Provider Business Mailing Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-5100
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:	615-936-0605

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-5100
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:	615-936-0605

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	10/15/2020

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