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General NPI Number Information
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NPI Number | 1104702729
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Entity Type | Organization
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Legal Business Name | PREMIER WOUND CARE OF TENNESSEE, PC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 1907 W MORRIS BLVD STE A200
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City | MORRISTOWN
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State | TN
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Zip | 37813-3880
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Country | US
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Telephone | 423-522-8700
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Fax | 423-522-8701
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Provider Business Mailing Address
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Address Line | 1326 PAPERMILL POINTE WAY
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City | KNOXVILLE
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State | TN
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Zip | 37909-1903
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Country | US
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Telephone | 423-522-8700
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Fax | 423-522-8701
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Authorized Official
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Title or Position | CREDENTIALING
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Name | LEONARD HALES
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Credential |
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Telephone | 615-403-4546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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