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General NPI Number Information
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NPI Number | 1942375571
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY AND URGENT CARE
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 18 ELDAD RD
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-7005
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Country | US
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Telephone | 931-438-8260
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Fax | 931-438-8257
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Provider Business Mailing Address
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Address Line | PO BOX 1118
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-1118
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Country | US
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Telephone | 931-438-8260
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Fax | 931-438-8257
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MELINDA T WILLIAMS
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Credential | NP
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Telephone | 931-438-8260
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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 | 5968
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License Number State | TN
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