Individual
JON GABRIEL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP-BC
Contact information
Practice address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(615) 873-7450
Mailing address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(615) 873-7450
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10899873-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
33381
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP138067
TX
Other
Enumeration date
07/16/2018
Last updated
09/14/2023
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