WHITEVILLE MEDICAL CLINIC LLC NPI 1073754636

NPI Information

NPI: 1073754636
Provider Name: WHITEVILLE MEDICAL CLINIC, LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 44D0949980

Address:
2060 US HIGHWAY 64
SUITE C
WHITEVILLE, TN
ZIP 38075
Phone: (901) 626-6626
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WHITEVILLE MEDICAL CLINIC, LLC is a family nurse practitioner in Whiteville, TN. WHITEVILLE MEDICAL CLINIC, LLC NPI is 1073754636. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2060 US HIGHWAY 64
SUITE C
WHITEVILLE, TN
ZIP 38075-476
Phone: (901) 626-6626

The provider's authorized official is Dee Blakney .
The authorized official title is Dnp and has the following contact phone number (901) 626-6626.

The CLIA number assigned to this NPI record is 44D0949980 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/11/2009 and was last updated on 3/11/2009.

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
1	363LA2200X	Nurse Practitioner	Adult Health			No
2	363LF0000X	Nurse Practitioner	Family			Yes

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: 5/5/2024

NPI Synchronization or Removal

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