Healthcare Provider Details

I. General information

NPI: 1780404301
Provider Name (Legal Business Name): EDELWEISS HOUSECALLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 PAYNE CIR
TAZEWELL TN
37879-4428
US

IV. Provider business mailing address

501 UNION ST STE 545 #836148
NASHVILLE TN
37219
US

V. Phone/Fax

Practice location:
  • Phone: 951-833-0214
  • Fax:
Mailing address:
  • Phone: 951-833-0214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA RAE GARVIN
Title or Position: OWNER
Credential: NP
Phone: 951-833-0214