Individual
GREGARY BYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
107 TENNESSEE ST, BOLIVAR, TN 38008-1822
(731) 212-3196
(731) 212-3193
Mailing address
107 TENNESSEE ST, BOLIVAR, TN 38008-1822
(731) 212-3196
(731) 212-3193
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
18850
TN
363LF0000X
Family Nurse Practitioner
18850
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q010912
—
TN
Enumeration date
07/10/2014
Last updated
02/18/2025
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