Provider Demographics
NPI:1295078798
Name:WESTBROOK, ATHA LOUIS II
Entity type:Individual
Prefix:
First Name:ATHA
Middle Name:LOUIS
Last Name:WESTBROOK
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AL
Other - Middle Name:
Other - Last Name:WESTBROOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:311 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1503
Mailing Address - Country:US
Mailing Address - Phone:615-340-0408
Mailing Address - Fax:
Practice Address - Street 1:311 23RD AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1503
Practice Address - Country:US
Practice Address - Phone:615-340-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker