Provider Demographics
NPI:1255480802
Name:VIERS, JEFFREY WAYNE (SR LPE)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:WAYNE
Last Name:VIERS
Suffix:
Gender:M
Credentials:SR LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 S CHURCH ST
Mailing Address - Street 2:SUITE 701
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-4984
Mailing Address - Country:US
Mailing Address - Phone:615-217-4432
Mailing Address - Fax:615-217-7411
Practice Address - Street 1:745 S CHURCH ST
Practice Address - Street 2:SUITE 701
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4984
Practice Address - Country:US
Practice Address - Phone:615-217-4432
Practice Address - Fax:615-217-7411
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11701103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4099861OtherBLUE CROSS BLUE SHIELD