Provider Demographics
NPI:1972166387
Name:LAURENZANO, JOHN PATRICK
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:LAURENZANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 BERNARD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4228
Mailing Address - Country:US
Mailing Address - Phone:413-265-6999
Mailing Address - Fax:
Practice Address - Street 1:1161 21ST AVE S
Practice Address - Street 2:D3100 MCN
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:615-875-5568
Practice Address - Fax:615-343-4466
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program