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General NPI Number Information
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NPI Number | 1194505776
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Entity Type | Organization
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Legal Business Name | TLC FAMILY HEALTH
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 2508 EDGEMONT DR STE 3
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-3844
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Country | US
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Telephone | 620-741-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 11663 182ND RD
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City | WINFIELD
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State | KS
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Zip | 67156-7907
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Country | US
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Telephone | 620-222-1248
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMMY L CULLUM
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Credential | APRN
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Telephone | 620-741-5430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care 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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