Healthcare Provider Details

I. General information

NPI: 1366918930
Provider Name (Legal Business Name): POINTE MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 MAIN STREET 2
OLIVER SPRINGS TN
37840-1761
US

IV. Provider business mailing address

705 MAIN STREET 2
OLIVER SPRINGS TN
37840
US

V. Phone/Fax

Practice location:
  • Phone: 865-280-1466
  • Fax: 865-285-9701
Mailing address:
  • Phone: 865-280-1466
  • Fax: 865-285-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. LANITA DEBOARD
Title or Position: OWNER
Credential: FNP
Phone: 865-280-1466