Organization
COLLINWOOD FAMILY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAYSHA A BRANTLEY APN (NURSE PRACTITIONER / OWNER)
(931) 724-4628
Entity
Organization
Contact information
Practice address
105 3RD AVE N, COLLINWOOD, TN 38450-4696
(931) 724-4628
(931) 724-4705
Mailing address
105 3RD AVE N, COLLINWOOD, TN 38450-4696
(931) 724-4628
(931) 724-4705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q004852
—
TN
05
—
Q060911
—
TN
Enumeration date
07/15/2020
Last updated
10/11/2024
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