Brenna Gillis

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20578 Issued in TN

Practice address

237 Castlewood Dr
Suite a
Murfreesboro, TN 37129-5165

Phone

(615) 494-4804

NPI assigned

Sep 24, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 15, 2016 through Jan 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1639548241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 BRITISH WOODS DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173336",
            "telephone_number": "920-979-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 CASTLEWOOD DR",
            "address_2": "SUITE A",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371295165",
            "telephone_number": "615-494-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "BRENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "203108",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "20578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Giles-Paul, DDS
• Meeghan Nichole Giles, D.P.M.
• Raymond A Giles, D.P.M.
• Nathan Darrell Gilley, M.D.
• Gillie Aesthetics and Dermatology, PLC
• Austin Gillogly, MD
• Diana Marie Gingrow
• Christin Marie Giordano McAuliffe, MD
• Heba Girgis
• Ginger L Givens Coley, O.D.

• Psychiatric/Mental Health Nurse Practitioner in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.