Healthcare Provider Details
I. General information
NPI: 1508027723
Provider Name (Legal Business Name): NP CLINICS OF TENNESSEE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2008
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
702 GROVE ST SUITE 204
LOUDON TN
37774-1481
US
IV. Provider business mailing address
702 GROVE ST SUITE 204
LOUDON TN
37774-1481
US
V. Phone/Fax
- Phone: 865-809-4326
- Fax:
- Phone: 865-809-4326
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | APN12184 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | APN12184 |
| License Number State | TN |
VIII. Authorized Official
Name:
LORETTA
R
TURBEVILLE
Title or Position: OWNER
Credential: APN, NP-C
Phone: 865-809-4326