Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 28150 | TN |
NPI | 1033724976 |
---|---|
Provider Name | Ms. Mara Talin Minasian |
First Address | Nashville, TN 37203-1582 |
Second Address | Nashville, TN 37203-1582 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 09/09/2020 |