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General NPI Number Information
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NPI Number | 1780404301
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Entity Type | Organization
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Legal Business Name | EDELWEISS HOUSECALLS
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 155 PAYNE CIR
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City | TAZEWELL
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State | TN
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Zip | 37879-4428
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Country | US
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Telephone | 951-833-0214
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Fax |
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Provider Business Mailing Address
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Address Line | 501 UNION ST STE 545 #836148
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City | NASHVILLE
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State | TN
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Zip | 37219
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Country | US
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Telephone | 951-833-0214
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA RAE GARVIN
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Credential | NP
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Telephone | 951-833-0214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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