Organization Name: | QUALITY MEDICAL CENTER OF UNION COUNTY |
NPI Number: | 1376898734 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTI S WALKER (OFFICE MANAGER) |
Mailing Address: | 3459 Maynardville Hwy Maynardville |
State: | TN US |
Postal Code: | 37807 |
Phone Number: | 8659923031 |
Fax Number: | |
NPI Enumeration Date: | 07/20/2012 |
NPI Last Update Date: | 09/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN0000014690 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |