Provider Demographics
NPI:1457507303
Name:BROYLES, MELISSA (CST-FA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BROYLES
Suffix:
Gender:F
Credentials:CST-FA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 HARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-1210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2011 CHURCH ST LOWR LEVER
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2000
Practice Address - Country:US
Practice Address - Phone:615-515-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN485276246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology