Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 30706 | TN |
Y | 363LN0000X | Nurse Practitioner - Neonatal | 30706 | TN |
NPI | 1013675818 |
---|---|
Provider Name | Nicole Rovang |
First Address | Nashville, TN 37215-2691 |
Second Address | Nashville, TN 37232-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 14/02/2022 |