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General NPI Number Information
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NPI Number | 1417504010
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Entity Type | Individual
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Provider Name | CORTNI MCCALL
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 580 W MAIN ST
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City | ALAMO
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State | TN
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Zip | 38001-1545
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Country | US
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Telephone | 731-394-1145
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Fax |
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Provider Business Mailing Address
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Address Line | 2835 REPUBLICAN GROVE RD
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City | ATWOOD
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State | TN
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Zip | 38220-4203
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Country | US
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Telephone | 731-487-2848
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 37374
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 228171
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License Number State | TN
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