Healthcare Provider Details

I. General information

NPI: 1598807984
Provider Name (Legal Business Name): MONROE COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 RAFTER RD
TELLICO PLAINS TN
37385-5862
US

IV. Provider business mailing address

PO BOX 38
MADISONVILLE TN
37354-0038
US

V. Phone/Fax

Practice location:
  • Phone: 423-442-3993
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberRN0000150194
License Number StateTN

VIII. Authorized Official

Name: MS. DIANE BOWERS
Title or Position: REGISTERED NURSE SUPERVISOR
Credential: R.N.
Phone: 423-442-3993