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General NPI Number Information
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NPI Number | 1811098908
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Entity Type | Individual
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Provider Name | FAY LYNN BEMBRY NP
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 119 BOONE RIDGE DRIVE STE. 201
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City | JOHNSON CITY
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State | TN
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Zip | 37615
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Country | US
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Telephone | 423-282-7480
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Fax | 423-928-1353
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Provider Business Mailing Address
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Address Line | 119 BOONE RIDGE DRIVE STE. 201
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City | JOHNSON CITY
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State | TN
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Zip | 37615
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Country | US
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Telephone | 423-282-7480
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Fax | 423-928-1353
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN6745
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 6745
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024167103
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License Number State | VA
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