Provider Demographics
NPI:1336864545
Name:ALAO-FESTUS, ANTHONIA
Entity Type:Individual
Prefix:
First Name:ANTHONIA
Middle Name:
Last Name:ALAO-FESTUS
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 1:2201 MURFREESBORO PIKE STE A106
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3469
Mailing Address - Country:US
Mailing Address - Phone:615-397-9971
Mailing Address - Fax:615-577-0790
Practice Address - Street 1:1263 SUMMER SHADE DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3896
Practice Address - Country:US
Practice Address - Phone:615-397-9971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN253Z00000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Yes253Z00000XAgenciesIn Home Supportive Care