FAMILY PRACTICE CLINIC PC NPI 1023380474

NPI Information

  • NPI: 1023380474
  • Provider Name: FAMILY PRACTICE CLINIC, PC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 44D0962574
  • Address: 1445 PARR AVE
    DYERSBURG, TN
    ZIP 38024
  • Phone: (731) 286-6156

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NPI Details

FAMILY PRACTICE CLINIC, PC is a family nurse practitioner in Dyersburg, TN. FAMILY PRACTICE CLINIC, PC NPI is 1023380474. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1445 PARR AVE
DYERSBURG, TN
ZIP 38024-153
Phone: (731) 286-6156
Fax: (731) 286-6797

The provider's authorized official is Mimi Ann Cherry .
The authorized official title is Clinic Manager and has the following contact phone number (731) 286-6156.

The CLIA number assigned to this NPI record is 44D0962574 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/1/2012 and was last updated on 2/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1363LF0000XNurse PractitionerFamily6331TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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