Basic Information
| Provider Information | |||||||||
| NPI: | 1386203669 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIDSON | ||||||||
| FirstName: | CORBIN | ||||||||
| MiddleName: | BLAIRE | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 608 NORRIS AVE | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372043708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156951432 | ||||||||
| FaxNumber: | 6156951483 | ||||||||
| Practice Location | |||||||||
| Address1: | 4230 HARDING PIKE STE 1000 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153832693 | ||||||||
| FaxNumber: | 6152971449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2019 | ||||||||
| LastUpdateDate: | 06/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 0000025722 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.