Provider Demographics
NPI:1487805560
Name:POLLOCK, BRIAN DAVID
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 21ST AVE S
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3160
Mailing Address - Country:US
Mailing Address - Phone:615-322-2028
Mailing Address - Fax:615-322-1578
Practice Address - Street 1:1500 21ST AVE S
Practice Address - Street 2:SUITE 2200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3160
Practice Address - Country:US
Practice Address - Phone:615-322-2028
Practice Address - Fax:615-322-1578
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13863363LP0808X
TN0000162421163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health