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General NPI Number Information
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NPI Number | 1629094461
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Entity Type | Organization
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Legal Business Name | WEST TENNESSEE WOMEN'S HEALTH CENTER
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 2555 N WASHINGTON AVE
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City | BROWNSVILLE
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State | TN
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Zip | 38012-1610
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Country | US
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Telephone | 731-779-0788
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Fax | 731-779-0971
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Provider Business Mailing Address
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Address Line | PO BOX 1798 DEPT. 07-053
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City | MEMPHIS
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State | TN
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Zip | 38101-1798
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Country | US
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Telephone | 731-779-0788
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Fax | 731-779-0971
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIE WILBURN-WREN
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Credential | M.D.
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Telephone | 731-779-0788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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