| Complete Ketamine Solutions | |
|
1916 Patterson St Ste 208 Nashville TN 37203-2126 | |
| (629) 203-7113 | |
| (629) 203-7138 |
| Full Name | Complete Ketamine Solutions |
|---|---|
| Speciality | Clinic/Center |
| Location | 1916 Patterson St Ste 208, Nashville, Tennessee |
| Authorized Official Name and Position | Clint Fletcher (OWNER) |
| Authorized Official Contact | 6153003096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Ketamine Solutions 1916 Patterson St Ste 208 Nashville TN 37203-2126 Ph: (629) 203-7113 | Complete Ketamine Solutions 1916 Patterson St Ste 208 Nashville TN 37203-2126 Ph: (629) 203-7113 |
| NPI Number | 1700548005 |
|---|---|
| Provider Enumeration Date | 10/13/2021 |
| Last Update Date | 10/13/2021 |
| Medicare PECOS PAC ID | 1153710116 |
|---|---|
| Medicare Enrollment ID | O20211111002942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700548005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Clinton Fletcher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215991658 PECOS PAC ID: 9638071459 Enrollment ID: I20040122000922 |
| Provider Name | Erica Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144851734 PECOS PAC ID: 4385065770 Enrollment ID: I20200611001520 |
| Provider Name | Monzur Haque |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639436314 PECOS PAC ID: 4183989122 Enrollment ID: I20211112000044 |
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