Basic Information
Provider Information
NPI: 1518327337
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORAM
FirstName: DENISE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3799
Address2:  
City: CLARKSVILLE
State: TN
PostalCode: 370433799
CountryCode: US
TelephoneNumber: 9312457000
FaxNumber: 9312457068
Practice Location
Address1: 490 DUNLOP LN
Address2:  
City: CLARKSVILLE
State: TN
PostalCode: 370405007
CountryCode: US
TelephoneNumber: 9312457000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/07/2016
LastUpdateDate: 08/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X20269TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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