Provider Demographics
NPI:1518079128
Name:REISENBERG, CATHERINE E (APRN, BC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:REISENBERG
Suffix:
Gender:F
Credentials:APRN, BC
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:222 GODCHAUX HALL
Mailing Address - Street 2:46121ST AVE SO
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37240-0001
Mailing Address - Country:US
Mailing Address - Phone:615-343-3250
Mailing Address - Fax:615-343-3327
Practice Address - Street 1:601 BENTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-292-9770
Practice Address - Fax:616-292-9706
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN6093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MR0852079OtherDEA
P66874Medicare UPIN