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General NPI Number Information
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NPI Number | 1770588683
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Entity Type | Organization
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Legal Business Name | GRUNDY COUNTY HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 740 MAIN ST
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City | TRACY CITY
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State | TN
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Zip | 37387-4020
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Country | US
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Telephone | 931-592-4242
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Fax | 931-592-4245
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Provider Business Mailing Address
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Address Line | 740 MAIN ST PO BOX 1449
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City | TRACY CITY
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State | TN
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Zip | 37387-1449
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Country | US
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Telephone | 931-592-4242
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Fax | 931-592-4245
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Authorized Official
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Title or Position | NURSE PRACTITIONER- PROVIDER
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Name | DEVON BREA LANGLEY
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Credential | FNP-C
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Telephone | 931-592-4242
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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 |
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License Number State |
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