Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 54160 | TN |
Y | 208000000X | Pediatrician | 54160 | TN |
NPI | 1326486150 |
---|---|
Provider Name | Amanda Lee Pratt |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2013 |
Last Update Date | 17/03/2018 |