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General NPI Number Information
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NPI Number | 1073965760
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Entity Type | Organization
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Legal Business Name | HIGH COUNTRY HOUSE CALL
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 1006 S JEFFERSON AVE
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City | WEST JEFFERSON
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State | NC
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Zip | 28694-9729
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Country | US
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Telephone | 336-909-4275
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Fax | 336-450-1854
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Provider Business Mailing Address
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Address Line | 1006 S JEFFERSON AVE
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City | WEST JEFFERSON
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State | NC
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Zip | 28694-9729
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Country | US
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Telephone | 336-909-4275
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Fax | 336-450-1854
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. SHIRLEY ANNE WARNER
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Credential | NP
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Telephone | 828-773-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5005546
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License Number State | NC
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