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General NPI Number Information
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NPI Number | 1841200177
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Entity Type | Organization
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Legal Business Name | LISA ROSS BIRTH AND WOMENS CENTER
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1925-B AILOR AVENUE
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City | KNOXVILLE
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State | TN
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Zip | 37921
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Country | US
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Telephone | 865-524-4422
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Fax | 865-523-3687
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Provider Business Mailing Address
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Address Line | 1925-B AILOR AVENUE
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City | KNOXVILLE
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State | TN
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Zip | 37921
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Country | US
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Telephone | 865-524-4422
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Fax | 865-523-3687
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LINDA J COLE
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Credential | CNM
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Telephone | 865-524-4422
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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 | 0000000004
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License Number State | TN
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