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General NPI Number Information
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NPI Number | 1326487554
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE FAMILY HEALTH, INC.
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 4900 NEW HIGHWAY 68
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City | MADISONVILLE
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State | TN
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Zip | 37354-2142
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Country | US
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Telephone | 423-545-9250
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Fax | 423-545-9631
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Provider Business Mailing Address
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Address Line | 4900 NEW HIGHWAY 68
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City | MADISONVILLE
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State | TN
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Zip | 37354-2142
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Country | US
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Telephone | 423-545-9250
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Fax | 423-545-9631
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Authorized Official
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Title or Position | FOUNDER
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Name | DEBORAH BRICKNER
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Credential |
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Telephone | 423-545-9250
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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