Individual
STACY DYCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
511 8TH ST, CLARKSVILLE, TN 37040-3093
(931) 920-7200
Mailing address
3134 HOLLY PT, CLARKSVILLE, TN 37043-8435
(615) 594-3581
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN0000026498
TN
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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