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General NPI Number Information
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NPI Number | 1720798580
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Entity Type | Individual
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Provider Name | BAILEY LYNN TULLIS FNP
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Gender | Female
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 1009 NOVUS DR STE 1A
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City | JOHNSON CITY
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State | TN
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Zip | 37604-8237
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Country | US
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Telephone | 423-282-2516
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Fax |
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Provider Business Mailing Address
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Address Line | 122 MOBLEY RD
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City | BLOUNTVILLE
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State | TN
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Zip | 37617-5429
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Country | US
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Telephone | 423-335-3245
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 32855
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License Number State | TN
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