Provider Demographics
NPI:1255577466
Name:MONROE CARELL JR VANDERBILT CHILDREN'S HOSPITAL
Entity type:Organization
Organization Name:MONROE CARELL JR VANDERBILT CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARHOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP
Authorized Official - Phone:615-936-1000
Mailing Address - Street 1:2200 CHILDRENS WAY
Mailing Address - Street 2:SUITE 4150
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0005
Mailing Address - Country:US
Mailing Address - Phone:615-936-2105
Mailing Address - Fax:615-936-1046
Practice Address - Street 1:2200 CHILDRENS WAY
Practice Address - Street 2:SUITE 4150
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-936-2105
Practice Address - Fax:615-936-1046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013691282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren