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General NPI Number Information
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NPI Number | 1952418030
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Entity Type | Organization
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Legal Business Name | BRAKEBILL NURSING HOME
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5837 LYONS VIEW PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-6474
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Country | US
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Telephone | 865-584-3902
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Fax | 865-584-2122
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Provider Business Mailing Address
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Address Line | 5837 LYONS VIEW PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-6474
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Country | US
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Telephone | 865-584-3902
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Fax | 865-584-2122
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MRS. KATHY ELAINE HAUN
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Credential |
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Telephone | 865-584-3902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | TN
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