Provider Demographics
NPI:1427508357
Name:CLAPSADDLE, BRYAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:CLAPSADDLE
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 FOX HOLLOW PL
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-9177
Mailing Address - Country:US
Mailing Address - Phone:931-358-0154
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-798-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-04
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21820363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care