Provider Demographics
NPI:1760939664
Name:CARROLL, BRIELLE MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BRIELLE
Middle Name:MARIE
Last Name:CARROLL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:53 CENTURY BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3693
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:860 MURFREESBORO PIKE
Practice Address - Street 2:APT J-11
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-1122
Practice Address - Country:US
Practice Address - Phone:616-826-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-11-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant