Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 59828 | TN |
NPI | 1053758516 |
---|---|
Provider Name | Nicole Kristen Perry |
First Address | Nashville, TN 37203-1706 |
Second Address | Nashville, TN 37203-1706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 12/09/2019 |