Healthcare Provider Details

I. General information

NPI: 1295974319
Provider Name (Legal Business Name): WAYNE E. TASKER AND ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2009
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 W ANDREW JOHNSON HWY
MORRISTOWN TN
37814-3728
US

IV. Provider business mailing address

1329 W ANDREW JOHNSON HWY
MORRISTOWN TN
37814-3728
US

V. Phone/Fax

Practice location:
  • Phone: 423-581-8844
  • Fax: 423-318-3050
Mailing address:
  • Phone: 423-581-8844
  • Fax: 423-318-3050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1050
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN11054
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN10446
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN12613
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP2658
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP2028
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP2741
License Number StateTN
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW5036
License Number StateTN
# 9
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW4923
License Number StateTN
# 10
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW4935
License Number StateTN
# 11
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW1208
License Number StateTN
# 12
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD14635
License Number StateTN

VIII. Authorized Official

Name: WAYNE E TASKER
Title or Position: PRESIDENT
Credential: LCSW
Phone: 423-581-8844