1033323159 NPI number — MS. CATHERINE MCCRACKEN KIRKLAND NP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033323159 NPI number — MS. CATHERINE MCCRACKEN KIRKLAND NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRKLAND
Provider First Name:
CATHERINE
Provider Middle Name:
MCCRACKEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCCRACKEN
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
FARISS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033323159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2801 CHARLOTTE AVE
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:
37209-4035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-250-9308
Provider Business Mailing Address Fax Number:
615-250-9251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
395 WALLACE RD.
Provider Second Line Business Practice Location Address:
SUITE 206B
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-331-8281
Provider Business Practice Location Address Fax Number:
615-331-3043
Provider Enumeration Date:
05/09/2007

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: 363L00000X , with the licence number:  APN12608 , 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)





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