Provider Demographics
NPI:1851155279
Name:MASON, CHRISTOPHER BRENT (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRENT
Last Name:MASON
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 KELLY ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-4246
Mailing Address - Country:US
Mailing Address - Phone:424-535-6636
Mailing Address - Fax:
Practice Address - Street 1:5911 SNOW HILL RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-9129
Practice Address - Country:US
Practice Address - Phone:424-535-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP002196363LP0808X
TN35884363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty