Basic Information
Provider Information
NPI: 1659717148
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGRAWAL
FirstName: NEENA
MiddleName: STEPHANIE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3601 THE VANDERBILT CLINIC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372326976
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/11/2013
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X54641TNN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X54641TNN Allopathic & Osteopathic PhysiciansHospitalist 
207SG0201X54641TNY Allopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)

No ID Information.


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