Provider Demographics
NPI:1366591802
Name:CASE, AUDREY JANE (APRN)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:JANE
Last Name:CASE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:A
Other - Middle Name:JANE
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:719 THOMPSON LN STE 30330
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 THE VANDERBILT CLINIC
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-5100
Practice Address - Country:US
Practice Address - Phone:615-322-3000
Practice Address - Fax:615-386-6299
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3345494Medicaid
TNMC0484876OtherDEA
TNS57598Medicare UPIN
TN3345498Medicare ID - Type Unspecified