Provider Demographics
NPI:1326224015
Name:VANDERBILT CHILDRENS HOSPITAL
Entity Type:Organization
Organization Name:VANDERBILT CHILDRENS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:VANDIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:615-936-0027
Mailing Address - Street 1:805 PARK DR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3147
Mailing Address - Country:US
Mailing Address - Phone:615-448-6034
Mailing Address - Fax:
Practice Address - Street 1:2200 CHILDRENS WAY STE 3115
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-936-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren