MEDICARE: MRS. DEBRA J. UNCAPHER FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	APN12680	TN
2	363LF0000X	Family Nurse Practitioner	0000060274	TN
3	363LF0000X	Family Nurse Practitioner	APN12680	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306062542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA J. UNCAPHER FNP-BC

Provider Business Mailing Address
First Line	:	1409 W MARKET ST STE 108
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-6005
Country	:	US
Telephone Number	:	423-833-0033
Fax Number	:	423-833-0031

Provider Business Practice Location Address
First Line	:	1409 W MARKET ST STE 108
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-6005
Country	:	US
Telephone Number	:	423-833-0033
Fax Number	:	423-833-0031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	02/11/2021

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