1184887580 NPI number — DR. AMANDA JEAN MOREHOUSE NGUYEN MD

Table of content: ANN TILLEY MD (NPI 1972720142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184887580 NPI number — DR. AMANDA JEAN MOREHOUSE NGUYEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOREHOUSE NGUYEN
Provider First Name:
AMANDA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOREHOUSE
Provider Other First Name:
AMANDA
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1184887580
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2004 HAYES ST STE 800
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-2659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-329-0570
Provider Business Mailing Address Fax Number:
615-329-0579

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
121 BEAR XING STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT JULIET
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37122-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-553-1084
Provider Business Practice Location Address Fax Number:
615-553-1115
Provider Enumeration Date:
07/07/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  64682 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 57094 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)