Basic Information
| Provider Information | |||||||||
| NPI: | 1255760971 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QAZAIT | ||||||||
| FirstName: | FATIN | ||||||||
| MiddleName: | SAID | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4230 HARDING PIKE | ||||||||
| Address2: | STE. 430 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152225500 | ||||||||
| FaxNumber: | 6152225601 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 PATTERSON ST STE 502 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372036511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155151900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2013 | ||||||||
| LastUpdateDate: | 05/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 17818 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 6026743 | 01 | TN | BCBST | OTHER | Q003634 | 05 | TN | MEDICAID |