Provider Demographics
NPI:1912292061
Name:NURSE PRACTITIONER ASSOCIATES
Entity type:Organization
Organization Name:NURSE PRACTITIONER ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADONDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, FNP
Authorized Official - Phone:615-596-8099
Mailing Address - Street 1:1307 BELL RD
Mailing Address - Street 2:# 111
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3745
Mailing Address - Country:US
Mailing Address - Phone:615-953-3633
Mailing Address - Fax:615-953-3635
Practice Address - Street 1:1307 BELL RD
Practice Address - Street 2:# 111
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3745
Practice Address - Country:US
Practice Address - Phone:615-953-3633
Practice Address - Fax:615-953-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care