Individual
ANDREA JENNIFER BODALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3441 DICKERSON PIKE, NASHVILLE, TN 37207-2539
(615) 769-2000
Mailing address
114 GATEWICK DR, JACKSON, TN 38305-6405
(602) 499-3987
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PENDING
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2021
Last updated
06/18/2024
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