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NPI Code Detail

MEDICARE: MS. MARY ELLEN KALMBACH APN

MEDICARE: MS. MARY ELLEN KALMBACH APN
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
1363L00000XNurse Practitioner7906TN

General Provider Information

NPI Number : 1770765489
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY ELLEN KALMBACH APN
Provider Business Mailing Address
First Line : 610 GALLATIN AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3225
Country : US
Telephone Number : 615-226-4330
Fax Number : 615-650-2565
Provider Business Practice Location Address
First Line : 610 GALLATIN AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3225
Country : US
Telephone Number : 615-226-4330
Fax Number : 615-650-2565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2007
Last Update Date : 12/04/2007

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