Provider Demographics
NPI:1578375788
Name:ANTHONY, BLAIR DANIELLE (NP)
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:DANIELLE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 SPENCER MILL RD
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:TN
Mailing Address - Zip Code:37029-5519
Mailing Address - Country:US
Mailing Address - Phone:615-557-8907
Mailing Address - Fax:
Practice Address - Street 1:1958 SPENCER MILL RD
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:TN
Practice Address - Zip Code:37029-5519
Practice Address - Country:US
Practice Address - Phone:615-504-7208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38013363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily