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General NPI Number Information
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NPI Number | 1033671003
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Entity Type | Organization
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Legal Business Name | STAT WELLNESS CENTER, PLLC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 1225 HAMPSHIRE PIKE
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City | COLUMBIA
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State | TN
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Zip | 38401-4615
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Country | US
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Telephone | 931-982-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 HAMPSHIRE PIKE
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City | COLUMBIA
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State | TN
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Zip | 38401-4615
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Country | US
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Telephone | 931-982-6333
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | AMY HARRIS
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Credential | FNP
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Telephone | 931-982-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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