MEDICARE: BRAYDEN FERNANDEZ PA-C

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	363A00000X	Physician Assistant	6165	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	:	1639858608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRAYDEN FERNANDEZ PA-C

Provider Business Mailing Address
First Line	:	2004 HAYES ST STE 800
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2659
Country	:	US
Telephone Number	:	615-329-0570
Fax Number	:	615-329-0579

Provider Business Practice Location Address
First Line	:	322 22ND AVE N STE 400
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1870
Country	:	US
Telephone Number	:	615-320-5090
Fax Number	:	615-320-1225

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

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	11/04/2025

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