Basic Information
| Provider Information | |||||||||
| NPI: | 1023204278 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STREICHER GREEN | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 20TH AVE N STE 403 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152847263 | ||||||||
| FaxNumber: | 6152847501 | ||||||||
| Practice Location | |||||||||
| Address1: | 1020 N HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371302494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153966620 | ||||||||
| FaxNumber: | 6153966624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2007 | ||||||||
| LastUpdateDate: | 12/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | DO2464 | TN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207Q00000X | 2464 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 6039532 | 01 | TN | SRIPA | OTHER | 602699 | 01 | TN | BCBST | OTHER | P01412339 | 01 | TN | RR MEDICARE | OTHER | Q001504 | 05 | TN | MEDICAID |