Basic Information
Provider Information
NPI: 1467095109
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MASSELL
FirstName: CHRISTINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2004 HAYES ST STE 800
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032659
CountryCode: US
TelephoneNumber: 6153290570
FaxNumber:  
Practice Location
Address1: 1840 MEDICAL CENTER PKWY STE 300
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371293237
CountryCode: US
TelephoneNumber: 6158480488
FaxNumber: 6159049061
Other Information
ProviderEnumerationDate: 10/25/2019
LastUpdateDate: 10/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X26767TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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