Provider Demographics
NPI:1033102728
Name:STOTT, NANCY JUNE (EDD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JUNE
Last Name:STOTT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 W END AVE
Mailing Address - Street 2:STE. 724
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2507
Mailing Address - Country:US
Mailing Address - Phone:615-320-5704
Mailing Address - Fax:615-320-5704
Practice Address - Street 1:1808 W END AVE
Practice Address - Street 2:STE. 724
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2507
Practice Address - Country:US
Practice Address - Phone:615-320-5704
Practice Address - Fax:615-320-5704
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP891103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3683415Medicare ID - Type Unspecified