Provider Demographics
NPI:1063900728
Name:MANNESCHMIDT, ANNA KATRINA (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KATRINA
Last Name:MANNESCHMIDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3786 CENTRAL PIKE STE 130
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3498
Mailing Address - Country:US
Mailing Address - Phone:615-883-2200
Mailing Address - Fax:615-883-1104
Practice Address - Street 1:3786 CENTRAL PIKE STE 130
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3498
Practice Address - Country:US
Practice Address - Phone:615-883-2200
Practice Address - Fax:615-883-1104
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN63703208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics