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General NPI Number Information
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NPI Number | 1386875987
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Entity Type | Organization
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Legal Business Name | HENSON'S FAMILY MEDICAL LLC
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 622 WILSON AVE
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City | TULLAHOMA
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State | TN
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Zip | 37388-3265
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Country | US
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Telephone | 931-393-2362
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Fax | 931-393-3210
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Provider Business Mailing Address
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Address Line | 622 WILSON AVE
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City | TULLAHOMA
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State | TN
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Zip | 37388-3265
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Country | US
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Telephone | 931-393-2362
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Fax | 931-393-3210
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Authorized Official
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Title or Position | FAMILY NIRSE PRACTITIONER
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Name | MRS. DEBORAH L EDWARDS
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Credential | NP-C
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Telephone | 931-393-2362
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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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