Individual
MARK ALAN STAUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 CHARLOTTE AVE, NASHVILLE, TN 37209-4129
(615) 340-5667
Mailing address
2713 PRIEST LAKE DR, NASHVILLE, TN 37217-4115
(615) 943-2645
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN146770
TN
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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