Individual
STEPHANIE DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2113 BRANSFORD AVE, NASHVILLE, TN 37204-2307
(615) 596-6104
Mailing address
2113 BRANSFORD AVE, NASHVILLE, TN 37204-2307
(615) 596-6104
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1000000017028
TN
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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