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General NPI Number Information
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NPI Number | 1942691878
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Entity Type | Organization
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Legal Business Name | ARISTORENAS HEALTH CLINIC
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 135 W MAIN ST
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City | ADAMSVILLE
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State | TN
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Zip | 38310-2203
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Country | US
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Telephone | 731-632-3373
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 311
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City | ADAMSVILLE
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State | TN
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Zip | 38310-0311
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Country | US
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Telephone | 731-632-3373
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | WANDA ARISTORENAS
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Credential | FNP-C
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Telephone | 731-607-4593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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