Healthcare Provider Details

I. General information

NPI: 1952625071
Provider Name (Legal Business Name): BRASHIER FAMILY MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 MAIN ST
CLIFTON TN
38425
US

IV. Provider business mailing address

133 MAIN ST
CLIFTON TN
38425
US

V. Phone/Fax

Practice location:
  • Phone: 931-676-3160
  • Fax: 931-676-3161
Mailing address:
  • Phone: 931-676-3160
  • Fax: 931-676-3161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7651
License Number StateTN

VIII. Authorized Official

Name: MR. CHARLES TREVOR BRASHIER
Title or Position: OWNER
Credential: APN
Phone: 931-676-3160