Basic Information
Provider Information
NPI: 1235670753
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TATE
FirstName: MEAGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 20TH AVE N
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032131
CountryCode: US
TelephoneNumber: 6152841400
FaxNumber: 6152841689
Practice Location
Address1: 300 20TH AVE N
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032131
CountryCode: US
TelephoneNumber: 6152841400
FaxNumber: 6152841689
Other Information
ProviderEnumerationDate: 03/16/2017
LastUpdateDate: 03/16/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X22466TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home