Provider Demographics
NPI:1639273626
Name:TENNESSEE VALLEY HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:TENNESSEE VALLEY HEALTH CARE SYSTEM
Other - Org Name:TENNESSEE STATE UNIVERSITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:RENAL TRANSPLANT NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:B
Authorized Official - Last Name:EDMUNDSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CFNP
Authorized Official - Phone:615-321-6373
Mailing Address - Street 1:PO BOX 110841
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37222-0841
Mailing Address - Country:US
Mailing Address - Phone:615-792-0202
Mailing Address - Fax:
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-321-6373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN00008329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty