Provider Demographics
NPI:1982406245
Name:NOZZA, GREGORY R (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:R
Last Name:NOZZA
Suffix:
Gender:
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 KEETON AVE
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-3807
Mailing Address - Country:US
Mailing Address - Phone:706-248-3915
Mailing Address - Fax:
Practice Address - Street 1:303 KEETON AVE
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-3807
Practice Address - Country:US
Practice Address - Phone:706-248-3915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38429363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health