Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 51172 | TN |
N | 208000000X | Pediatrician | 128424 | OH |
N | 208000000X | Pediatrician | MD51172 | TN |
NPI | 1013208115 |
---|---|
Provider Name | Michaela Ibach |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-1063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2011 |
Last Update Date | 15/10/2020 |