Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 25101 | TN |
N | 363LA2100X | Nurse Practitioner - Acute Care | APN25101 | TN |
Y | 363LG0600X | Nurse Practitioner - Gerontology | APN25101 | TN |
NPI | 1073080099 |
---|---|
Provider Name | Mary Mendoza-Romine |
First Address | Nashville, TN 37204-3609 |
Second Address | Nashville, TN 37204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2018 |
Last Update Date | 15/10/2020 |