| Evergreen Nephrology Pllc | |
|
210 Athens Way Ste 200 Nashville TN 37228-1308 | |
| (515) 270-3505 | |
| (833) 633-1290 |
| Full Name | Evergreen Nephrology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 210 Athens Way Ste 200, Nashville, Tennessee |
| Authorized Official Name and Position | Jonathan Fieldstein (OWNER) |
| Authorized Official Contact | 2406430900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Nephrology Pllc 210 Athens Way Ste 200 Nashville TN 37228-1308 Ph: (515) 270-3505 | Evergreen Nephrology Pllc 210 Athens Way Ste 200 Nashville TN 37228-1308 Ph: (515) 270-3505 |
| NPI Number | 1982305082 |
|---|---|
| Provider Enumeration Date | 03/15/2023 |
| Last Update Date | 03/15/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 1850758491 |
|---|---|
| Medicare Enrollment ID | O20230613002402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982305082 | NPI | - | NPPES |
| Provider Name | Emily Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811538580 PECOS PAC ID: 7416367230 Enrollment ID: I20220818001838 |
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