Provider Demographics
NPI:1205696614
Name:NATHOO, TAYLA NIRVANA
Entity type:Individual
Prefix:
First Name:TAYLA
Middle Name:NIRVANA
Last Name:NATHOO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TRISTAR CENTENNIAL GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:2300 PATTERSON ST
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:TRISTAR CENTENNIAL GRADUATE MEDICAL EDUCATION
Practice Address - Street 2:2300 PATTERSON ST
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-342-3969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program