MOSCOW FAMILY MEDICALLLC NPI 1548828304

NPI Information

NPI: 1548828304
Provider Name: MOSCOW FAMILY MEDICAL,LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 44D2170815

Address:
13775 HIGHWAY 57 STE 4
MOSCOW, TN
ZIP 38057
Phone: (901) 877-3070
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MOSCOW FAMILY MEDICAL,LLC is a family nurse practitioner in Moscow, TN. MOSCOW FAMILY MEDICAL,LLC NPI is 1548828304. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13775 HIGHWAY 57 STE 4
MOSCOW, TN
ZIP 38057-802
Phone: (901) 877-3070

The provider's authorized official is Zelma Allen .
The authorized official title is Owner and has the following contact phone number (901) 877-3070.

The CLIA number assigned to this NPI record is 44D2170815 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2019 and was last updated on 6/18/2019.

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			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: 4/28/2024

NPI Synchronization or Removal

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