MEDICARE: HIGHLAND BEHAVIORAL HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1093325557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND BEHAVIORAL HEALTHCARE

Provider Business Mailing Address
First Line	:	63 TAYLOR AVE
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-4567
Country	:	US
Telephone Number	:	931-250-5488
Fax Number	:	931-250-5667

Provider Business Practice Location Address
First Line	:	63 TAYLOR AVE
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-4567
Country	:	US
Telephone Number	:	931-250-5488
Fax Number	:	931-250-5667

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	JENNIFER ANN OLSEN
Credential	:
Telephone Number	:	931-250-5488

Provider Enumeration Date	:	08/08/2020
Last Update Date	:	12/03/2025

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