Healthcare Provider Details

I. General information

NPI: 1003737420
Provider Name (Legal Business Name): CORTNEY MYERS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E BROADWAY BLVD STE 205
JEFFERSON CITY TN
37760-2837
US

IV. Provider business mailing address

317 18TH AVE N STE 200
NASHVILLE TN
37203-2253
US

V. Phone/Fax

Practice location:
  • Phone: 865-999-0601
  • Fax: 865-471-8191
Mailing address:
  • Phone: 615-292-3661
  • Fax: 615-292-3662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: