Provider Demographics
NPI:1841756145
Name:SUTTON, MARIAH ANGELA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARIAH
Middle Name:ANGELA
Last Name:SUTTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:ANGELA
Other - Last Name:GLASSCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1507 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-5913
Mailing Address - Country:US
Mailing Address - Phone:816-309-5485
Mailing Address - Fax:
Practice Address - Street 1:3441 DICKERSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2539
Practice Address - Country:US
Practice Address - Phone:615-769-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN204986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine