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General NPI Number Information
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NPI Number | 1477870525
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Entity Type | Organization
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Legal Business Name | STUMB HEALTHCARE PROFESSIONALS, LLC
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 619 N. MAIN ST
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City | CARTHAGE
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State | TN
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Zip | 37030
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Country | US
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Telephone | 615-489-7256
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Fax |
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Provider Business Mailing Address
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Address Line | 236 DIXON SPRINGS HW
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City | CARTHAGE
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State | TN
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Zip | 37030
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Country | US
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Telephone | 615-489-7256
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | CRISTY STUMB
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Credential | DNP APRN BC
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Telephone | 615-489-7256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 14465
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License Number State | TN
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