Basic Information
Provider Information
NPI: 1194240663
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COPE
FirstName: STUART
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3005 AMBROSE AVE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372074709
CountryCode: US
TelephoneNumber: 8446736968
FaxNumber: 4467369688
Practice Location
Address1: 3441 DICKERSON PIKE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372072539
CountryCode: US
TelephoneNumber: 8446736968
FaxNumber: 8446736968
Other Information
ProviderEnumerationDate: 08/07/2017
LastUpdateDate: 11/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X22902TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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