Provider Demographics
NPI:1851482921
Name:BURROW, TANCI CHARIESS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:TANCI
Middle Name:CHARIESS
Last Name:BURROW
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:TANCI
Other - Middle Name:CHARIESS
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:6236 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134
Mailing Address - Country:US
Mailing Address - Phone:901-425-4300
Mailing Address - Fax:901-620-6342
Practice Address - Street 1:6236 STAGE RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3726
Practice Address - Country:US
Practice Address - Phone:901-425-4300
Practice Address - Fax:901-620-6342
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN93791363L00000X, 363LF0000X
ARA003207363LP0808X
TNAPN6733363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN363LP0808XMedicare PIN
TN363LF0000XMedicare PIN