Provider Demographics
NPI:1245674019
Name:RICH, MARIEL BENTZ (APN)
Entity type:Individual
Prefix:
First Name:MARIEL
Middle Name:BENTZ
Last Name:RICH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-385-3704
Mailing Address - Fax:615-292-1321
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 435
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:615-292-1321
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN184291363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care