Individual
MAIMA MASSAQUOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1101 KERMIT DR STE 204, NASHVILLE, TN 37217-5102
(615) 365-4424
Mailing address
1101 KERMIT DR STE 204, NASHVILLE, TN 37217-5102
(615) 365-4424
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
88428
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88428
NURSING LICENSE
TN
Enumeration date
09/10/2019
Last updated
03/03/2021
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