Provider Demographics
NPI:1588238349
Name:BROYLES, EMILI MEHGAN (CNM)
Entity Type:Individual
Prefix:
First Name:EMILI
Middle Name:MEHGAN
Last Name:BROYLES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BENTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2303
Mailing Address - Country:US
Mailing Address - Phone:615-292-9770
Mailing Address - Fax:
Practice Address - Street 1:601 BENTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2303
Practice Address - Country:US
Practice Address - Phone:615-292-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367A00000X
TN29439367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife