EAST TENNESSEE STATE UNIVERSITY NPI 1952785081

NPI Information

EAST TENNESSEE STATE UNIVERSITY is a family nurse practitioner in Jonesborough, TN. EAST TENNESSEE STATE UNIVERSITY NPI is 1952785081. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lamar Elementary School Clinic.

The provider's business location address is:

3261 TN 81
JONESBOROUGH, TN
ZIP 37659
Phone: (423) 753-1130
Fax: (423) 439-4560

The provider's authorized official is Betty J King .
The authorized official title is Acting Chief Financial Officer and has the following contact phone number (423) 439-4414.

The CLIA number assigned to this NPI record is 44D2171877 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/18/2015 and was last updated on 2/23/2017.

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:

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