Individual
STACY TRICIA TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4102 DOCTORS OFFICE TOWER, 2200 CHILDREN'S WAY, NASHVILLE, TN 37232-0001
(615) 936-1060
(615) 936-1061
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 936-2000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A83339
CA
208800000X
Urology Physician
MD44860
TN
2088P0231X
Pediatric Urology Physician
Primary
44860
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44860
MEDICAL LICENSE
TN
01
—
A83339
MEDICAL LICENSE
CA
Enumeration date
02/24/2006
Last updated
03/29/2022
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