Healthcare Provider Details

I. General information

NPI: 1295273043
Provider Name (Legal Business Name): MALONES GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2017
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 W DUE WEST AVE SUITE 105
MADISON TN
37115-4431
US

IV. Provider business mailing address

612 AIDEEN PL
MADISON TN
37115-4283
US

V. Phone/Fax

Practice location:
  • Phone: 615-403-5468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. TIERNY DEBNAM
Title or Position: OFFICE MANAGER
Credential:
Phone: 615-977-9233