Organization
VANDERBILT INTEGRATED PROVIDERS, LLC
Active
Other names
Vanderbilt Pediatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY MONACI (VICE PRESIDENT)
(615) 936-3944
Entity
Organization
Contact information
Practice address
4235 FORT CAMPBELL BLVD, HOPKINSVILLE, KY 42240-9339
(270) 560-0075
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
03/08/2021
Last updated
03/31/2022
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