Basic Information
Provider Information
NPI: 1497199301
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRUNER
FirstName: ERIN
MiddleName: PRESTON
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 353 NEW SHACKLE ISLAND RD STE 341C
Address2:  
City: HENDERSONVILLE
State: TN
PostalCode: 370752354
CountryCode: US
TelephoneNumber: 6158261716
FaxNumber: 6158264841
Practice Location
Address1: 353 NEW SHACKLE ISLAND RD STE 341C
Address2:  
City: HENDERSONVILLE
State: TN
PostalCode: 370752354
CountryCode: US
TelephoneNumber: 6158261716
FaxNumber: 6158264841
Other Information
ProviderEnumerationDate: 04/22/2013
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207V00000X55756TNY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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