Provider Demographics
NPI:1073562963
Name:NYGARD, NORMAN KORTNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:KORTNER
Last Name:NYGARD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5364 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6234
Mailing Address - Country:US
Mailing Address - Phone:615-573-8069
Mailing Address - Fax:615-333-0676
Practice Address - Street 1:5364 VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-6234
Practice Address - Country:US
Practice Address - Phone:615-573-8069
Practice Address - Fax:615-333-0676
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001595103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3686265Medicaid
TN265363000OtherBCBS GROUP #
TN4026707OtherBCBS INDIVIDUAL
TN3686265Medicaid
TN265363000OtherBCBS GROUP #