Provider Demographics
NPI:1215902564
Name:DY, DESIREE BELLE UY (FNP)
Entity type:Individual
Prefix:
First Name:DESIREE BELLE
Middle Name:UY
Last Name:DY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 SEMINOLE CT
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3339
Mailing Address - Country:US
Mailing Address - Phone:615-733-0211
Mailing Address - Fax:615-733-0212
Practice Address - Street 1:1421 ELM HILL PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210
Practice Address - Country:US
Practice Address - Phone:615-733-0211
Practice Address - Fax:615-733-0212
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN103734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902652Medicare ID - Type UnspecifiedSMYRNA MEDICARE #
TN3903212Medicare ID - Type UnspecifiedDOVER MEDICARE #
TN3902651Medicare ID - Type UnspecifiedWB MEDICARE #
TN3902650Medicare ID - Type UnspecifiedRG MEDICARE #
TNS17774Medicare UPIN