Provider Demographics
NPI:1477681435
Name:GARRISON, NANCY L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:GARRISON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 AEDC RD
Mailing Address - Street 2:
Mailing Address - City:ESTILL SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37330-3915
Mailing Address - Country:US
Mailing Address - Phone:931-392-4169
Mailing Address - Fax:931-392-4187
Practice Address - Street 1:11144 TULLAHOMA HIGHWAY
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-6016
Practice Address - Country:US
Practice Address - Phone:931-454-9994
Practice Address - Fax:931-455-5086
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002340103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4313470OtherBLUE CROSS
TN1527892Medicaid
TN4313470OtherBLUE CROSS