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HEALTHY LIFE CLINIC INC. NPI 1437389731


NPI Information

NPI: 1437389731
Provider Name: HEALTHY LIFE CLINIC, INC.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
110 PERIMETER PARK RD.
SUITE G
KNOXVILLE, TN
ZIP 37922
Phone: (865) 247-6340
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HEALTHY LIFE CLINIC, INC. is a family nurse practitioner in Knoxville, TN. HEALTHY LIFE CLINIC, INC. NPI is 1437389731. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

110 PERIMETER PARK RD.
SUITE G
KNOXVILLE, TN
ZIP 37922-200
Phone: (865) 247-6340
Fax: (865) 951-2617

The provider's authorized official is Gary R. Bickford .
The authorized official title is Owner and has the following contact phone number (865) 247-6340.

The enumeration date for this NPI number is 7/21/2009 and was last updated on 1/27/2012.


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 PractitionerFamilyAPN0000012264TENNESSEEYes

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 Other Provider Identifier Issuer
11517282MEDICAIDTENNESSEE

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
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