Provider Demographics
NPI:1255662243
Name:DIDIEGO, MICHELE (APN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:DIDIEGO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST
Mailing Address - Street 2:STE. 700
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1826
Mailing Address - Country:US
Mailing Address - Phone:615-913-5086
Mailing Address - Fax:888-494-2588
Practice Address - Street 1:4413 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-2367
Practice Address - Country:US
Practice Address - Phone:423-664-1140
Practice Address - Fax:888-965-6806
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN173162163W00000X
TN14671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse