Provider Demographics
NPI:1598752958
Name:VAVRA, DANIELA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELA
Middle Name:
Last Name:VAVRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:PITRIKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4200 STAMMER PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3308
Mailing Address - Country:US
Mailing Address - Phone:615-463-9900
Mailing Address - Fax:615-463-8092
Practice Address - Street 1:4200 STAMMER PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3308
Practice Address - Country:US
Practice Address - Phone:615-463-9900
Practice Address - Fax:615-463-8092
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8201363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP45854Medicare UPIN
TN3342362Medicare ID - Type UnspecifiedBELMONT MEDICAL
TN3342361Medicare ID - Type UnspecifiedOLYMPIC MEDICAL