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NPI Code Detail

MEDICARE: EAST TENNESSEE SKILLED CARE

MEDICARE: EAST TENNESSEE SKILLED CARE
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
1163W00000XRegistered NurseRN166309TN
2363LF0000XFamily Nurse PractitionerAPN15811TN

General Provider Information

NPI Number : 1649604489
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST TENNESSEE SKILLED CARE
Provider Business Mailing Address
First Line : PO BOX 4300
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37602-4300
Country : US
Telephone Number : 423-773-9555
Fax Number : 423-913-4123
Provider Business Practice Location Address
First Line : 140 TECHNOLOGY LN
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-2004
Country : US
Telephone Number : 423-773-9555
Fax Number : 423-913-4123
Authorized Official
Title or Position : FAMILY NURSE PRACTITIONER/CEO
Name : MRS. EMMALEA ELIZABETH JOHNSTON
Credential : FNP
Telephone Number : 423-773-9555
Provider Enumeration Date : 08/28/2013
Last Update Date : 10/17/2013

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Directions to “EAST TENNESSEE SKILLED CARE ” Practice Location

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