MEDICARE: MALINA AUSTIN

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
2	363A00000X	Physician Assistant	5154	TN

General Provider Information

NPI Number	:	1659023133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALINA AUSTIN

Provider Business Mailing Address
First Line	:	5713 CALIFORNIA AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-1416
Country	:	US
Telephone Number	:	601-260-7284
Fax Number	:

Provider Business Practice Location Address
First Line	:	6746 CHARLOTTE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4204
Country	:	US
Telephone Number	:	629-203-7585
Fax Number	:	629-203-7857

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

Provider Enumeration Date	:	01/25/2022
Last Update Date	:	09/19/2022

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Directions to “ MALINA AUSTIN ” Practice Location

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