Healthcare Provider Details

I. General information

NPI: 1780313346
Provider Name (Legal Business Name): DOLLIE VICTORIA BYRON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 CROSSROADS BLVD STE 400
BRENTWOOD TN
37027-2826
US

IV. Provider business mailing address

7084 SONYA DR
NASHVILLE TN
37209-5230
US

V. Phone/Fax

Practice location:
  • Phone: 615-457-8585
  • Fax:
Mailing address:
  • Phone: 615-692-9560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN0000031606
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: