Basic Information
| Provider Information | |||||||||
| NPI: | 1619254141 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERDOWSI | ||||||||
| FirstName: | NIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 20TH AVE N | ||||||||
| Address2: | 9TH FLOOR | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032131 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 300 20TH AVE N | ||||||||
| Address2: | 9TH FLOOR | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152841400 | ||||||||
| FaxNumber: | 6152844970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2011 | ||||||||
| LastUpdateDate: | 01/21/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS11509 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2588 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.