QUALITY MEDICAL CENTER OF UNION COUNTY - NPI NUMBER 1376898734

Summary

Provider Name: QUALITY MEDICAL CENTER OF UNION COUNTY

NPI Number: 1376898734

Clasification: Nurse Practitioner (363LF0000X)

Specialization: Family

Address:
3459 MAYNARDVILLE HWY
MAYNARDVILLE, TN
ZIP 37807

Phone Number: (865) 992-3031



Detailed Information

QUALITY MEDICAL CENTER OF UNION COUNTY is a family nurse practitioner in Maynardville, TN. The assigned NPI number for this provider is 1376898734 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

3459 MAYNARDVILLE HWY
MAYNARDVILLE, TN
ZIP 37807
Phone: (865) 992-3031

The provider's authorized official is Kristi S Walker .
The authorized official title is Office Manager and has the following contact phone number (865) 992-3031.

The enumeration date for this NPI number is 7/20/2012 and was last updated on 9/7/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363LF0000X Nurse Practitioner Family APN0000014690 TN Yes

NPI Record

No. Field Name Field Value
1 NPI 1376898734
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name QUALITY MEDICAL CENTER OF UNION COUNTY
5 Provider First Line Business Practice Location Address 3459 MAYNARDVILLE HWY
6 Provider Business Practice Location Address City Name MAYNARDVILLE
7 Provider Business Practice Location Address State Name TN
8 Provider Business Practice Location Address Postal Code 37807
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 8659923031
11 Provider Enumeration Date 7/20/2012
12 Last Update Date 9/7/2012
13 Authorized Official Last Name WALKER
14 Authorized Official First Name KRISTI
15 Authorized Official Middle Name S
16 Authorized Official Title or Position OFFICE MANAGER
17 Authorized Official Telephone Number 8659923031
18 Healthcare Provider Taxonomy Code 1 363LF0000X
19 Provider License Number 1 APN0000014690
20 Provider License Number State Code 1 TN
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Organization Subpart N
23 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.