Individual
JORGE ENRIQUE CELEDONIO COLQUICOCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-0011
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000248465
TN
363LA2100X
Acute Care Nurse Practitioner
30563
TN
363LG0600X
Gerontology Nurse Practitioner
Primary
30563
TN
Other
Enumeration date
10/05/2021
Last updated
03/26/2022
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