Provider Demographics
NPI:1467764555
Name:VANDERBILT MEDICAL CENTER
Entity Type:Organization
Organization Name:VANDERBILT MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAUMA ACUTE CARE NURSE PRACTITIONE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:ACNP-BC
Authorized Official - Phone:615-887-8075
Mailing Address - Street 1:370 OAKLEY DR APT 1109
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6971
Mailing Address - Country:US
Mailing Address - Phone:216-401-3152
Mailing Address - Fax:
Practice Address - Street 1:338 MEDICAL ARTS BLDG 1750
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-887-8075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2010002576282N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282N00000XHospitalsGeneral Acute Care Hospital