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NPI Code Detail

MEDICARE: MISTY ANN PREWITT

MEDICARE:   MISTY ANN PREWITT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist1066TN

General Provider Information

NPI Number : 1407674245
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTY ANN PREWITT
Provider Business Mailing Address
First Line : 4142 S 7TH ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-4123
Country : US
Telephone Number : 423-239-5361
Fax Number : 800-524-8107
Provider Business Practice Location Address
First Line : 516 W OAKLAND AVE STE 106
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-1677
Country : US
Telephone Number : 423-328-1244
Fax Number : 423-282-8397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2024
Last Update Date : 10/01/2024

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Directions to “ MISTY ANN PREWITT ” Practice Location

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