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NPI Code Detail

MEDICARE: JOAN ANTHONY NP-C

MEDICARE: JOAN ANTHONY NP-C
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
1363LA2200XAdult Health Nurse Practitioner20478TN
2363LG0600XGerontology Nurse Practitioner20478TN
3363LP2300XPrimary Care Nurse Practitioner20478TN

General Provider Information

NPI Number : 1639549421
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN ANTHONY NP-C
Provider Business Mailing Address
First Line : 319 BROAD ST
Second Line : PO BOX 175
City : BAXTER
State : TN
Zip : 38544
Country : US
Telephone Number : 931-858-2116
Fax Number : 931-858-2117
Provider Business Practice Location Address
First Line : 319 BROAD ST
Second Line :
City : BAXTER
State : TN
Zip : 38544-5117
Country : US
Telephone Number : 931-858-2116
Fax Number : 931-858-2117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2015
Last Update Date : 03/17/2018

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