Provider Demographics
NPI:1043806516
Name:SRIVASTAVA, PREETI (APRN)
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:SRIVASTAVA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PRITI
Other - Middle Name:SRIVASTAVA
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1325 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3786
Mailing Address - Country:US
Mailing Address - Phone:629-333-3820
Mailing Address - Fax:
Practice Address - Street 1:1325 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3786
Practice Address - Country:US
Practice Address - Phone:629-333-3820
Practice Address - Fax:629-333-3824
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000028769363LP0808X, 363LP0808X
TNRN00001958762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry