Provider Demographics
NPI:1225264518
Name:CLARKSVILLE ADVANCED PRACTICE PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:CLARKSVILLE ADVANCED PRACTICE PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:931-237-4699
Mailing Address - Street 1:2141 OLD ASHLAND CITY RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4906
Mailing Address - Country:US
Mailing Address - Phone:931-237-4699
Mailing Address - Fax:931-553-8544
Practice Address - Street 1:2141 OLD ASHLAND CITY RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4906
Practice Address - Country:US
Practice Address - Phone:931-237-4699
Practice Address - Fax:931-553-8544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000008121363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty