Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APN14381 | TN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 14381 | TN |
NPI | 1255564753 |
---|---|
Provider Name | Mr. Fred Ryan Truesdale |
First Address | Nashville, TN 37232-2183 |
Second Address | Nashville, TN 37232-2183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2009 |
Last Update Date | 09/10/2012 |