Provider Demographics
NPI:1164568358
Name:NANJI, ARTEE D (OD)
Entity Type:Individual
Prefix:
First Name:ARTEE
Middle Name:D
Last Name:NANJI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11860 CRANSTON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4886
Mailing Address - Country:US
Mailing Address - Phone:901-867-5540
Mailing Address - Fax:
Practice Address - Street 1:11860 CRANSTON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-4886
Practice Address - Country:US
Practice Address - Phone:901-867-5540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2510152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3590066OtherMEDICARE INDIVIDUAL PTAN
35900661OtherMEDICARE GROUP/ORGANIZATION PTAN