Provider Demographics
NPI:1518574706
Name:NANDIGAM NEUROLOGY, LLC
Entity Type:Organization
Organization Name:NANDIGAM NEUROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:NANDIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:615-667-0031
Mailing Address - Street 1:PO BOX 11498
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0030
Mailing Address - Country:US
Mailing Address - Phone:615-667-0031
Mailing Address - Fax:877-846-2357
Practice Address - Street 1:20 MEDICAL CAMPUS DR NW STE 202
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4094
Practice Address - Country:US
Practice Address - Phone:910-755-5565
Practice Address - Fax:877-876-2357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty