Provider Demographics
NPI:1205985488
Name:BROOKSHIRE, NANCY STOUGHTON (FNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:STOUGHTON
Last Name:BROOKSHIRE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2776
Mailing Address - Country:US
Mailing Address - Phone:931-684-3426
Mailing Address - Fax:931-684-5860
Practice Address - Street 1:140 DOVER ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2776
Practice Address - Country:US
Practice Address - Phone:931-684-3426
Practice Address - Fax:931-684-5860
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN58240OtherRN
TN5729OtherAPN