Provider Demographics
NPI:1174702351
Name:BARZYK, TISHA C (DNP, AGACNP-BC, CWS)
Entity type:Individual
Prefix:DR
First Name:TISHA
Middle Name:C
Last Name:BARZYK
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2127
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-1711
Mailing Address - Country:US
Mailing Address - Phone:844-673-6968
Mailing Address - Fax:844-673-6968
Practice Address - Street 1:3005 AMBROSE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-4709
Practice Address - Country:US
Practice Address - Phone:844-673-6968
Practice Address - Fax:844-673-6968
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TN12996363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341511Medicaid