Provider Demographics
NPI:1942338512
Name:MASSIE, GLORIA JEAN (HS)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:JEAN
Last Name:MASSIE
Suffix:
Gender:F
Credentials:HS
Other - Prefix:
Other - First Name:SAMI
Other - Middle Name:
Other - Last Name:MASSIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HS
Mailing Address - Street 1:2307 CLOVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3004
Mailing Address - Country:US
Mailing Address - Phone:615-883-3144
Mailing Address - Fax:
Practice Address - Street 1:654 W IRIS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3191
Practice Address - Country:US
Practice Address - Phone:615-269-5170
Practice Address - Fax:615-269-8015
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider