Organization Name: | COVINGTON HEALTHCARE LLC |
NPI Number: | 1881095560 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH GWINN (BUSINESS CONSULTANT) |
Mailing Address: | 1608-a Gilmer Ave Tallassee |
State: | AL US |
Postal Code: | 360782314 |
Phone Number: | 3347825028 |
Fax Number: | 3347825028 |
NPI Enumeration Date: | 09/12/2014 |
NPI Last Update Date: | 09/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-049268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |