Provider Demographics
NPI:1578330445
Name:DAUBENMIER, GRACE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:DAUBENMIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PLUS PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-1026
Mailing Address - Country:US
Mailing Address - Phone:615-881-2673
Mailing Address - Fax:
Practice Address - Street 1:143 SE PARKWAY CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3968
Practice Address - Country:US
Practice Address - Phone:615-790-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program