Healthcare Provider Details

I. General information

NPI: 1033034327
Provider Name (Legal Business Name): BROOKE NICHOLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 615-292-3661
  • Fax: 615-292-3662
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: