Basic Information
| Provider Information | |||||||||
| NPI: | 1528449022 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | GEORGIA | ||||||||
| MiddleName: | LEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1921 RANSOM PL | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372173841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152796700 | ||||||||
| FaxNumber: | 6154636603 | ||||||||
| Practice Location | |||||||||
| Address1: | 1921 RANSOM PL | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372173841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152796700 | ||||||||
| FaxNumber: | 6154636603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2015 | ||||||||
| LastUpdateDate: | 06/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | 118060989 | TN | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.