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General NPI Number Information
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NPI Number | 1750906335
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Entity Type | Organization
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Legal Business Name | BRAY FAMILY HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 35 SPIVEY ST
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City | RED BOILING SPRINGS
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State | TN
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Zip | 37150-2078
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Country | US
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Telephone | 615-699-7425
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Fax | 615-699-7427
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Provider Business Mailing Address
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Address Line | 35 SPIVEY ST
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City | RED BOILING SPRINGS
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State | TN
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Zip | 37150-2078
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Country | US
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Telephone | 615-699-7425
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Fax | 615-699-7427
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BEVERLY J COLTER
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Credential |
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Telephone | 615-699-7425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 |
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License Number State |
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