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General NPI Number Information
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NPI Number | 1619412871
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Entity Type | Organization
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Legal Business Name | TENNESSEE FAMILY CLINIC
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 1565 WAYNE RD
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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 | 859-948-7915
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1387
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City | SAVANNAH
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State | TN
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Zip | 38372-4387
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | KATHERINE FORSBACH
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Credential | FNP-C
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Telephone | 859-948-7915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 000879494
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License Number State | TN
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