Provider Demographics
NPI:1780366443
Name:BLAIR, SCHELBY HANSON (PMHNP-C)
Entity type:Individual
Prefix:
First Name:SCHELBY
Middle Name:HANSON
Last Name:BLAIR
Suffix:
Gender:F
Credentials:PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 W JAMES M CAMPBELL BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4659
Mailing Address - Country:US
Mailing Address - Phone:931-540-4140
Mailing Address - Fax:931-540-4142
Practice Address - Street 1:854 W JAMES M CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4674
Practice Address - Country:US
Practice Address - Phone:931-540-4140
Practice Address - Fax:931-540-4142
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34286363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health