CUMBERLAND GAP MEDICAL NPI 1336563204

NPI Information

  • NPI: 1336563204
  • Provider Name: CUMBERLAND GAP MEDICAL
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 44D2041170
  • Address: 502 W CENTRAL AVE
    SUITE 2
    LA FOLLETTE, TN
    ZIP 37766
  • Phone: (423) 201-9799

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NPI Details

CUMBERLAND GAP MEDICAL is a family nurse practitioner in La Follette, TN. CUMBERLAND GAP MEDICAL NPI is 1336563204. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

502 W CENTRAL AVE
SUITE 2
LA FOLLETTE, TN
ZIP 37766-400
Phone: (423) 201-9799
Fax: (423) 437-8162

The provider's authorized official is Amanda Sue Collins .
The authorized official title is Nurse Practitioner and has the following contact phone number (423) 201-9799.

The CLIA number assigned to this NPI record is 44D2041170 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2014 and was last updated on 2/12/2014.

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 PractitionerFamilyAPN0000016605TENNESSEEYes

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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