1538170857 NPI number — MS. KAREN RUTH NASH LCSW

Table of content: DR. OLGA CALDERON-BANZON MD (NPI 1942202775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538170857 NPI number — MS. KAREN RUTH NASH LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NASH
Provider First Name:
KAREN
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHEELER
Provider Other First Name:
KAREN
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538170857
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1718 PATTERSON ST
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:
37203-2926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-327-1085
Provider Business Mailing Address Fax Number:
615-963-4733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-963-4732
Provider Business Practice Location Address Fax Number:
615-963-4733
Provider Enumeration Date:
08/11/2006

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: 1041C0700X , with the licence number:  765 , 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)

  • Identifier: 3730393 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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