Provider Demographics
NPI:1609088731
Name:BUMBALOUGH, MATTHEW REED (MSN, APRN, BC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:REED
Last Name:BUMBALOUGH
Suffix:
Gender:M
Credentials:MSN, APRN, BC
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Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 THE VANDERBILT CLINIC
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-5100
Practice Address - Country:US
Practice Address - Phone:615-322-3000
Practice Address - Fax:615-936-0605
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily