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General NPI Number Information
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NPI Number | 1538671631
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Entity Type | Organization
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Legal Business Name | QUALLS HARBIN FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 255 RIVERSIDE DRIVE
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City | SAVANNAH
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State | TN
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Zip | 38372
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Country | US
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Telephone | 731-438-3765
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Fax | 731-438-3767
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Provider Business Mailing Address
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Address Line | PO BOX 445
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City | SAVANNAH
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State | TN
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Zip | 38372-0445
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Country | US
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Telephone | 731-438-3765
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Fax | 731-438-3767
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Authorized Official
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Title or Position | FNP/OWNER
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Name | LAUREN HARBIN
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Credential | FNP
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Telephone | 731-438-3765
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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 | APN0000021321
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License Number State | TN
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