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Individual

MS. MARY ELIZABETH BACIGALUPO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CCRN, ACNP, APRN

Contact information

Practice address
4220 HARDING PIKE, NASHVILLE, TN 37205-2005
(615) 222-4097
(615) 222-3687
Mailing address
4220 HARDING PIKE, NASHVILLE, TN 37205-2005
(615) 222-4097
(615) 222-3687

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5549P
KY
363LA2200X
Adult Health Nurse Practitioner
APN13258
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000562599
ANTHEM BCBS
KY
05
7100043830
KY
Enumeration date
03/14/2008
Last updated
08/11/2009
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