Healthcare Provider Details

I. General information

NPI: 1356068613
Provider Name (Legal Business Name): PAUL MICHAEL PRISTAS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 10/26/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 MALLORY LN STE 200
FRANKLIN TN
37067-2842
US

IV. Provider business mailing address

106 FOUNDERS POINTE BLVD
FRANKLIN TN
37064-0704
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-1100
  • Fax:
Mailing address:
  • Phone: 239-734-1699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN0000032806
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: