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General NPI Number Information
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NPI Number | 1982922316
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Entity Type | Organization
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Legal Business Name | LIFETIME FAMILY HEALTH CLINIC
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 2255 HIGHWAY 25E SUITE 2
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City | TAZEWELL
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State | TN
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Zip | 37879-3857
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Country | US
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Telephone | 423-626-0300
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Fax | 423-626-0314
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Provider Business Mailing Address
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Address Line | PO BOX 1588
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City | NEW TAZEWELL
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State | TN
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Zip | 37824-1588
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Country | US
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Telephone | 423-626-0300
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Fax | 423-626-0314
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE R ARNS
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Credential | NP
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Telephone | 423-626-0300
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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 | APN0000012915
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License Number State | TN
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