Provider Demographics
NPI:1184602450
Name:TYSON, TAMMY LOUISE (FNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LOUISE
Last Name:TYSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:LOUISE
Other - Last Name:TYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:
Practice Address - Street 1:7735 FARMINGTON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2901
Practice Address - Country:US
Practice Address - Phone:901-757-6805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS332675YR80Medicare PIN