=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376243980
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAUREN RACHELLE CURTIS RDH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2023
-----------------------------------------------------
Last Update Date | 03/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 N MEADOWS DR
-----------------------------------------------------
City | ATHENS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37303-4172
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-744-8400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 269 GAY LEE LN
-----------------------------------------------------
City | TELLICO PLAINS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37385-5702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-253-4088
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------