Provider Demographics
NPI:1609978048
Name:BRANTLEY, DAYSHA A (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DAYSHA
Middle Name:A
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:COLLINWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:38450-4696
Mailing Address - Country:US
Mailing Address - Phone:931-724-4628
Mailing Address - Fax:931-724-4705
Practice Address - Street 1:105 3RD AVE N
Practice Address - Street 2:
Practice Address - City:COLLINWOOD
Practice Address - State:TN
Practice Address - Zip Code:38450-4696
Practice Address - Country:US
Practice Address - Phone:931-724-4628
Practice Address - Fax:931-724-4705
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3644731Medicaid
TN3644731Medicaid
TN3644731Medicare PIN