Provider Demographics
NPI:1134867351
Name:SAWYER, TOMMY LEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:TOMMY
Middle Name:LEE
Last Name:SAWYER
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2289 RUDOLPHTOWN RD STE B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2231
Mailing Address - Country:US
Mailing Address - Phone:931-552-3031
Mailing Address - Fax:931-552-9820
Practice Address - Street 1:2289 RUDOLPHTOWN RD STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2231
Practice Address - Country:US
Practice Address - Phone:931-552-3031
Practice Address - Fax:931-552-9820
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN230069163W00000X
TN57733183700000X
TN31795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No183700000XPharmacy Service ProvidersPharmacy Technician