Healthcare Provider Details

I. General information

NPI: 1285698563
Provider Name (Legal Business Name): ELIZABETH GRACE PRIESTLEY APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129
US

IV. Provider business mailing address

3400 LEBANON RD
MURFREESBORO TN
37129-1392
US

V. Phone/Fax

Practice location:
  • Phone: 615-519-0426
  • Fax:
Mailing address:
  • Phone: 615-867-6000
  • Fax: 615-225-5381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number140000
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number8408
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: