Provider Demographics
NPI:1992770119
Name:VANDERBILT MEDICAL CENTER
Entity type:Organization
Organization Name:VANDERBILT MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED REGISTERED NURSE PRACTITIO
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:615-591-9886
Mailing Address - Street 1:1103 DICKINSON LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4720
Mailing Address - Country:US
Mailing Address - Phone:615-591-9886
Mailing Address - Fax:
Practice Address - Street 1:S-3414 MEDICAL CENTER NORTH
Practice Address - Street 2:C/O INTERNAL MEDICINE DEPT
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-835-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006961282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital