Provider Demographics
NPI:1477196004
Name:LAJERET, BRIE (DNP, PMHNP, AGPCNP)
Entity Type:Individual
Prefix:
First Name:BRIE
Middle Name:
Last Name:LAJERET
Suffix:
Gender:F
Credentials:DNP, PMHNP, AGPCNP
Other - Prefix:
Other - First Name:BRIE
Other - Middle Name:
Other - Last Name:SICARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2855
Mailing Address - Country:US
Mailing Address - Phone:615-446-1349
Mailing Address - Fax:
Practice Address - Street 1:127 CRESTVIEW PL
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1067
Practice Address - Country:US
Practice Address - Phone:615-446-1349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-27
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN00000026701363LA2200X
TNAPN0000026701363LG0600X, 363LP2300X
TN26701363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care