| Elite Psychiatry Of Tennessee Llc | |
|
403 Henslee Dr Dickson TN 37055-2166 | |
| (615) 637-3131 | |
| (931) 208-3616 |
| Full Name | Elite Psychiatry Of Tennessee Llc |
|---|---|
| Speciality | Physician Assistant |
| Location | 403 Henslee Dr, Dickson, Tennessee |
| Authorized Official Name and Position | Kd Wainwright (OWNER) |
| Authorized Official Contact | 6156373131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Psychiatry Of Tennessee Llc 403 Henslee Dr Dickson TN 37055-2166 Ph: (615) 637-3131 | Elite Psychiatry Of Tennessee Llc 403 Henslee Dr Dickson TN 37055-2166 Ph: (615) 637-3131 |
| NPI Number | 1023733557 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 05/24/2024 |
| Certification Date | 05/24/2024 |
| Medicare PECOS PAC ID | 2365811692 |
|---|---|
| Medicare Enrollment ID | O20221208002352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023733557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Provider Name | Brittany Mckay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184330698 PECOS PAC ID: 7012380983 Enrollment ID: I20230224001419 |
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