Organization
MID TN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOLA GABRIEL PA (CO-OWNER/MANAGER)
(615) 569-4067
Entity
Organization
Contact information
Practice address
3413 NOLENSVILLE PIKE, NASHVILLE, TN 37211-2909
(615) 569-4067
Mailing address
3413 NOLENSVILLE PIKE, NASHVILLE, TN 37211-2909
Taxonomy
Speciality
Code
Description
License number
State
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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