Individual
MRS. BRYN MAYBERRY SOUTHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
490 LONG HOLLOW PIKE, GOODLETTSVILLE, TN 37072-3480
(555) 555-5555
Mailing address
5880 ASHLAND CITY HWY, NASHVILLE, TN 37218-4222
(615) 525-6977
(615) 695-1483
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1436
TN
363AM0700X
Medical Physician Assistant
PA1436
TN
Other
Enumeration date
10/13/2006
Last updated
10/28/2025
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