Provider Demographics
NPI:1477738052
Name:BEATTY, PRISCILLA (NP)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:BEATTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4260 LONGFELLOW DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-1259
Mailing Address - Country:US
Mailing Address - Phone:615-473-2469
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST STE 215
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6501
Practice Address - Country:US
Practice Address - Phone:615-342-7345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN136315163WG0100X
TNAPN8331363L00000X
TN8331363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN150352Medicaid
TN4177190OtherBCBS OF TN