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General NPI Number Information
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NPI Number | 1215236039
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Entity Type | Organization
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Legal Business Name | WEIGHT LOSS SOLUTIONS AND MORE PLLC
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 878 N MOUNT JULIET RD
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City | MOUNT JULIET
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State | TN
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Zip | 37122-3391
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Country | US
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Telephone | 615-773-5999
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Fax | 615-773-5999
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Provider Business Mailing Address
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Address Line | PO BOX 628
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City | LEBANON
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State | TN
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Zip | 37088-0628
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Country | US
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Telephone | 615-773-5999
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Fax | 615-773-5999
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER A PETTY
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Credential | ANP
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Telephone | 615-773-5999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11466
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License Number State | TN
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