Healthcare Provider Details

I. General information

NPI: 1881820892
Provider Name (Legal Business Name): FRIENDS AND FAMILY HEALTHCARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 03/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 HWY 70 E SUITE 6
DICKSON TN
37055-7039
US

IV. Provider business mailing address

118 HWY 70 E SUITE 6
DICKSON TN
37055-7039
US

V. Phone/Fax

Practice location:
  • Phone: 615-810-8440
  • Fax: 615-810-8441
Mailing address:
  • Phone: 615-810-8440
  • Fax: 615-810-8441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13099
License Number StateTN

VIII. Authorized Official

Name: MR. BOBBY P AGUAYO
Title or Position: MANAGING MEMBER
Credential: FNP
Phone: 615-810-8440