Provider Demographics
NPI:1639968910
Name:CAPORASO, ENRICO ANTHONY (FNP-C)
Entity type:Individual
Prefix:
First Name:ENRICO
Middle Name:ANTHONY
Last Name:CAPORASO
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2195
Mailing Address - Country:US
Mailing Address - Phone:205-706-1889
Mailing Address - Fax:
Practice Address - Street 1:1068 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2195
Practice Address - Country:US
Practice Address - Phone:205-706-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine