Healthcare Provider Details

I. General information

NPI: 1871590075
Provider Name (Legal Business Name): DANA T PAPWORTH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANA T OSMUNDSON PA-C

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W 7TH NORTH ST
MORRISTOWN TN
37814-3957
US

IV. Provider business mailing address

502 W 7TH NORTH ST
MORRISTOWN TN
37814-3957
US

V. Phone/Fax

Practice location:
  • Phone: 423-586-1818
  • Fax: 423-254-1762
Mailing address:
  • Phone: 423-586-1818
  • Fax: 423-254-1762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number921
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: