Healthcare Provider Details

I. General information

NPI: 1144602574
Provider Name (Legal Business Name): HARROGATE HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 WESTMORELAND ST
HARROGATE TN
37752-8202
US

IV. Provider business mailing address

165 WESTMORELAND ST
HARROGATE TN
37752-8202
US

V. Phone/Fax

Practice location:
  • Phone: 423-441-8011
  • Fax: 423-441-8014
Mailing address:
  • Phone: 423-441-8011
  • Fax: 423-441-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMY JO BUSSELL
Title or Position: FAMILY NURSE PRACTITIONER
Credential: ARNP
Phone: 423-441-8011