Organization
EAST NASHVILLE PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BREANNA LUSTRE MD (OWNER)
(615) 882-4900
Entity
Organization
Contact information
Practice address
3926 GALLATIN PIKE STE B, NASHVILLE, TN 37216-2436
(917) 846-9609
Mailing address
1612 SUMNER AVE, NASHVILLE, TN 37206-2536
(917) 846-9609
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
04/16/2021
Last updated
10/01/2021
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