ACNE & ROSACEA CLINICS NPI 1356593545

NPI Information

NPI: 1356593545
Provider Name: ACNE & ROSACEA CLINICS
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
907 VANN DRIVE SUITE M
JACKSON, TN
ZIP 38305
Phone: (731) 668-5000
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ACNE & ROSACEA CLINICS is a family nurse practitioner in Jackson, TN. ACNE & ROSACEA CLINICS NPI is 1356593545. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

907 VANN DRIVE SUITE M
JACKSON, TN
ZIP 38305-046
Phone: (731) 668-5000
Fax: (731) 668-5122

The provider's authorized official is Mary Beth Cox .
The authorized official title is Owner and has the following contact phone number (731) 668-5000.

The enumeration date for this NPI number is 10/21/2008 and was last updated on 10/21/2008.

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	363LF0000X	Nurse Practitioner	Family	APN8135	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	P55449	MEDICARE UPIN	TENNESSEE
2	3906025	MEDICAID	TENNESSEE
3	3906025	MEDICARE PIN	TENNESSEE

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: 11/14/2023

NPI Synchronization or Removal

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