Provider Demographics
NPI:1720621311
Name:TRIPURE, FERNANDA SOUZA (APRN)
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:SOUZA
Last Name:TRIPURE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:FERNANDA
Other - Middle Name:F
Other - Last Name:CARVALHO DE SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3039 BRECKENRIDGE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2101
Practice Address - Country:US
Practice Address - Phone:812-941-3080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009538A363LF0000X
KY3015623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily