Provider Demographics
NPI:1932989217
Name:KANTROW, ELEANOR B (PA-C)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:B
Last Name:KANTROW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 VANTAGE WAY APT 2410
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1640
Mailing Address - Country:US
Mailing Address - Phone:504-583-0480
Mailing Address - Fax:
Practice Address - Street 1:45 VANTAGE WAY APT 2410
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1640
Practice Address - Country:US
Practice Address - Phone:504-583-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant