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General NPI Number Information
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NPI Number | 1386108462
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Entity Type | Individual
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Provider Name | LILLIAN AMBER MCCALL MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 2300 W STONE DR
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City | KINGSPORT
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State | TN
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Zip | 37660-2360
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Country | US
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Telephone | 423-246-4961
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 W STONE DR
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City | KINGSPORT
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State | TN
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Zip | 37660-2360
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Country | US
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Telephone | 423-246-4961
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Fax | 423-245-3136
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 209670
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 25392
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License Number State | TN
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