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General NPI Number Information
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NPI Number | 1972141620
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE - BEMIS, LLC
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1385 S HIGHLAND AVE STE B4
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City | JACKSON
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State | TN
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Zip | 38301-7547
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Country | US
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Telephone | 731-300-7755
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Fax | 731-300-0773
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Provider Business Mailing Address
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Address Line | 1385 S HIGHLAND AVE STE B4
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City | JACKSON
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State | TN
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Zip | 38301-7547
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Country | US
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Telephone | 731-300-7755
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Fax | 731-300-0773
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Authorized Official
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Title or Position | OFFICE ADMIN
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Name | CHASITY HORNBURGER
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Credential |
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Telephone | 731-300-7755
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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 |
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License Number State |
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