MEDICARE: DR. KIMBERLY GRAN NAFTEL MD

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	207P00000X	Emergency Medicine Physician	MD.28868	AL
2	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	MD49810	TN
3	208000000X	Pediatrics Physician	MD.28868	AL
4	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	49810	TN
5	390200000X	Student in an Organized Health Care Education/Training Program
6	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	MD49810	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	515-91059	OTHER		BCBS
2	1760539571	OTHER	AL	TRICARE SOUTH
3	515-91061	OTHER	AL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760539571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY GRAN NAFTEL MD

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-322-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-9001
Country	:	US
Telephone Number	:	615-322-5000
Fax Number	:

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	11/20/2024

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