Provider Demographics
NPI:1699986943
Name:NAGINENI, LAVANYA LATHA (MD)
Entity type:Individual
Prefix:DR
First Name:LAVANYA
Middle Name:LATHA
Last Name:NAGINENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 SKYLINE MEDICAL CENTER,
Mailing Address - Street 2:SUITE 580
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-0000
Mailing Address - Country:US
Mailing Address - Phone:615-860-1040
Mailing Address - Fax:615-860-1242
Practice Address - Street 1:3443 DICKERSON PIKE STE 580
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2526
Practice Address - Country:US
Practice Address - Phone:615-860-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN682252084N0400X
CAA933172084N0400X
TXM95242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201060501Medicaid
8F9957Medicare PIN