Provider Demographics
NPI:1952625071
Name:BRASHIER FAMILY MEDICAL
Entity type:Organization
Organization Name:BRASHIER FAMILY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:TREVOR
Authorized Official - Last Name:BRASHIER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:931-676-3160
Mailing Address - Street 1:133 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TN
Mailing Address - Zip Code:38425
Mailing Address - Country:US
Mailing Address - Phone:931-676-3160
Mailing Address - Fax:931-676-3161
Practice Address - Street 1:133 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TN
Practice Address - Zip Code:38425
Practice Address - Country:US
Practice Address - Phone:931-676-3160
Practice Address - Fax:931-676-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7651363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP30014Medicare UPIN
TN3901277Medicare PIN