Provider Demographics
NPI:1780340679
Name:SPIELMAN, DAVID WALLACE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WALLACE
Last Name:SPIELMAN
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 21ST AVE S STE 401
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4930
Mailing Address - Country:US
Mailing Address - Phone:615-212-5810
Mailing Address - Fax:833-391-0867
Practice Address - Street 1:2323 21ST AVE S STE 401
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4930
Practice Address - Country:US
Practice Address - Phone:615-212-5810
Practice Address - Fax:833-391-0867
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33965363LP0808X
TN257428163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty