Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 30723 | TN |
NPI | 1083284285 |
---|---|
Provider Name | Olivia Looney |
First Address | Nashville, TN 37208-1794 |
Second Address | Nashville, TN 37203-1538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2021 |
Last Update Date | 02/12/2021 |