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General NPI Number Information
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NPI Number | 1659277465
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Entity Type | Individual
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Provider Name | BROOKNEY JAIDE VIATOR
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Gender | Female
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Dates
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Enumeration Date | 10/19/2026
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Last Update Date | 10/19/2026
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Provider Practice Location Address
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Address Line | 560 SW COOK RD
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City | MT JULIET
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State | TN
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Zip | 37122-6328
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Country | US
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Telephone | 615-970-1847
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Fax |
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Provider Business Mailing Address
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Address Line | 560 SW COOK RD
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City | MT JULIET
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State | TN
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Zip | 37122-6328
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Country | US
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Telephone | 615-970-1847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 43217
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License Number State | TN
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