Organization Name: | PHYSCIANS ELDERCARE |
NPI Number: | 1023061140 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERI LYNNE HARMON (PROVIDER SPECIALIST SERVICES) |
Mailing Address: | 3880 Vest Mill Rd Winston-salem |
State: | NC US |
Postal Code: | 271031323 |
Phone Number: | 3362455403 |
Fax Number: | 3362511116 |
NPI Enumeration Date: | 05/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | STUDENT |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |