Provider Demographics
NPI:1629127303
Name:SANFILIPPO, JOSEPH (NP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SANFILIPPO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 CHEVOIT DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-6137
Mailing Address - Country:US
Mailing Address - Phone:615-988-2340
Mailing Address - Fax:615-988-2643
Practice Address - Street 1:4901 NOLENSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5411
Practice Address - Country:US
Practice Address - Phone:615-988-2340
Practice Address - Fax:615-988-2643
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN8448363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441731Medicaid
TN3341305Medicare PIN