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General NPI Number Information
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NPI Number | 1629905906
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Entity Type | Individual
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Provider Name | MRS. VIRGINIA K STREET
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Gender | Female
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER BLVD
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City | COOKEVILLE
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State | TN
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Zip | 38501-4294
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Country | US
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Telephone | 931-528-2541
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Fax | 931-528-2541
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Provider Business Mailing Address
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Address Line | 108 JOHN YOUNG LN
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City | HILHAM
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State | TN
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Zip | 38568-5927
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Country | US
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Telephone | 931-310-3688
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Fax | 931-783-5226
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 96978
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License Number State | TN
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