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General NPI Number Information
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NPI Number | 1740415025
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Entity Type | Organization
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Legal Business Name | JEFFERSON HEARTS CONSULTANTS
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 120 HOSPITAL DR SUITE 250
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City | JEFFERSON CITY
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State | TN
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Zip | 37760-5287
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Country | US
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Telephone | 865-471-2570
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Fax | 865-471-2571
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Provider Business Mailing Address
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Address Line | 120 HOSPITAL DR SUITE 250
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City | JEFFERSON CITY
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State | TN
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Zip | 37760-5287
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Country | US
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Telephone | 865-471-2570
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Fax | 865-471-2571
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR/DIRECTOR
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Name | SUSANNE NELMS
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Credential |
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Telephone | 865-549-4892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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