Healthcare Provider Details

I. General information

NPI: 1124765151
Provider Name (Legal Business Name): BRIANNA NICOLE SHRUM CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250B OLD WOLF HILL RD
BETHPAGE TN
37022-8515
US

IV. Provider business mailing address

250B OLD WOLF HILL RD
BETHPAGE TN
37022-8515
US

V. Phone/Fax

Practice location:
  • Phone: 615-998-6413
  • Fax:
Mailing address:
  • Phone: 615-998-6413
  • Fax: 615-622-8757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: